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Prospective analysis of long-term renal function in survivors of childhood Wilms tumor

Background Considering the improved outcome, a better understanding of the late effects in Wilms tumor survivors (WT-S) is needed. This study was aimed at evaluating renal function and determining the prevalence of clinical and subclinical renal dysfunction in a cohort of WT-S using a multimodal dia... Full description

Journal Title: Pediatric nephrology (Berlin West), 2017, Vol.32 (10), p.1915-1925
Main Author: Neu, Marie A
Other Authors: Russo, Alexandra , Wingerter, Arthur , Alt, Francesca , Theruvath, Johanna , El Malki, Khalifa , Kron, Bettina , Dittrich, Matthias , Lotz, Johannes , Stein, Raimund , Beetz, Rolf , Faber, Joerg
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0931-041X
Link: https://www.ncbi.nlm.nih.gov/pubmed/28451896
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recordid: cdi_proquest_journals_1934089094
title: Prospective analysis of long-term renal function in survivors of childhood Wilms tumor
format: Article
creator:
  • Neu, Marie A
  • Russo, Alexandra
  • Wingerter, Arthur
  • Alt, Francesca
  • Theruvath, Johanna
  • El Malki, Khalifa
  • Kron, Bettina
  • Dittrich, Matthias
  • Lotz, Johannes
  • Stein, Raimund
  • Beetz, Rolf
  • Faber, Joerg
subjects:
  • Adolescent
  • Adult
  • Age determination
  • Analysis
  • Antineoplastic Agents - adverse effects
  • Blood pressure
  • Cancer Survivors - statistics & numerical data
  • Care and treatment
  • Chemotherapy
  • Chemotherapy, Adjuvant
  • Children
  • Chronic kidney failure
  • Cross-Sectional Studies
  • Cystatin
  • Diagnosis
  • End-stage renal disease
  • Epidermal growth factor receptors
  • Excretion
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Health aspects
  • Humans
  • Hypertension
  • Hypertrophy
  • Kidney - diagnostic imaging
  • Kidney - drug effects
  • Kidney - physiopathology
  • Kidney - surgery
  • Kidney diseases
  • Kidney Neoplasms - mortality
  • Kidney Neoplasms - physiopathology
  • Kidney Neoplasms - therapy
  • Kidney transplantation
  • Male
  • Medicine
  • Medicine & Public Health
  • Middle Aged
  • Morbidity
  • Nephrectomy - adverse effects
  • Nephrectomy - methods
  • Nephroblastoma
  • Nephrology
  • Original Article
  • Pediatrics
  • Prevalence
  • Prospective Studies
  • Proteinuria - epidemiology
  • Proteinuria - physiopathology
  • Proteinuria - urine
  • Radiation
  • Radiation therapy
  • Radiotherapy
  • Renal function
  • Renal Insufficiency, Chronic - epidemiology
  • Renal Insufficiency, Chronic - physiopathology
  • Renal Insufficiency, Chronic - urine
  • Risk factors
  • Surgery
  • Ultrasonography
  • Urology
  • Usage
  • Wilms Tumor - mortality
  • Wilms Tumor - physiopathology
  • Wilms Tumor - therapy
  • Young Adult
ispartof: Pediatric nephrology (Berlin, West), 2017, Vol.32 (10), p.1915-1925
description: Background Considering the improved outcome, a better understanding of the late effects in Wilms tumor survivors (WT-S) is needed. This study was aimed at evaluating renal function and determining the prevalence of clinical and subclinical renal dysfunction in a cohort of WT-S using a multimodal diagnostic approach. Methods Thirty-seven WT-S were included in this prospective cross-sectional single center study. To evaluate renal function, glomerular filtration rate (GFR) and urinary protein excretion were assessed. Additionally, kidney sonomorphology and blood pressure were analyzed. Results All examined WT-S (mean age 28.7 years, mean follow-up 24.8 years) had been treated with a combination of surgery and chemotherapy; 59.5% had received adjuvant radiotherapy. Impaired glomerular renal function was detected in a considerable proportion of WT-S, with age-adjusted cystatin-based GFR estimation below age norm in 55.9%. A lower cystatin-based estimated GFR (eGFR) correlated with longer follow-up time and higher irradiation dose. In 5 patients (13.5%) albuminuria was identified. Analysis of sonomorphology detected compensatory contralateral renal hypertrophy in 83.3% of WT-S. Chronic kidney disease (CKD) ≥ stage II was present in 55.9% of WT-S. Blood pressure measurements revealed arterial hypertension in 15 (40.5%) WT-S (newly diagnosed n =10). In 24.3% both CKD ≥ stage II and arterial hypertension were determined. Conclusion Even though WT-S are believed to carry a low risk for end-stage renal disease, in this study, a remarkable number of WT-S presented with previously unidentified subclinical signs of renal function impairment and secondary morbidity. Therefore, it is important to continue regular follow-up, especially after transition into adulthood.
language: eng
source:
identifier: ISSN: 0931-041X
fulltext: no_fulltext
issn:
  • 0931-041X
  • 1432-198X
url: Link


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titleProspective analysis of long-term renal function in survivors of childhood Wilms tumor
creatorNeu, Marie A ; Russo, Alexandra ; Wingerter, Arthur ; Alt, Francesca ; Theruvath, Johanna ; El Malki, Khalifa ; Kron, Bettina ; Dittrich, Matthias ; Lotz, Johannes ; Stein, Raimund ; Beetz, Rolf ; Faber, Joerg
creatorcontribNeu, Marie A ; Russo, Alexandra ; Wingerter, Arthur ; Alt, Francesca ; Theruvath, Johanna ; El Malki, Khalifa ; Kron, Bettina ; Dittrich, Matthias ; Lotz, Johannes ; Stein, Raimund ; Beetz, Rolf ; Faber, Joerg
descriptionBackground Considering the improved outcome, a better understanding of the late effects in Wilms tumor survivors (WT-S) is needed. This study was aimed at evaluating renal function and determining the prevalence of clinical and subclinical renal dysfunction in a cohort of WT-S using a multimodal diagnostic approach. Methods Thirty-seven WT-S were included in this prospective cross-sectional single center study. To evaluate renal function, glomerular filtration rate (GFR) and urinary protein excretion were assessed. Additionally, kidney sonomorphology and blood pressure were analyzed. Results All examined WT-S (mean age 28.7 years, mean follow-up 24.8 years) had been treated with a combination of surgery and chemotherapy; 59.5% had received adjuvant radiotherapy. Impaired glomerular renal function was detected in a considerable proportion of WT-S, with age-adjusted cystatin-based GFR estimation below age norm in 55.9%. A lower cystatin-based estimated GFR (eGFR) correlated with longer follow-up time and higher irradiation dose. In 5 patients (13.5%) albuminuria was identified. Analysis of sonomorphology detected compensatory contralateral renal hypertrophy in 83.3% of WT-S. Chronic kidney disease (CKD) ≥ stage II was present in 55.9% of WT-S. Blood pressure measurements revealed arterial hypertension in 15 (40.5%) WT-S (newly diagnosed n =10). In 24.3% both CKD ≥ stage II and arterial hypertension were determined. Conclusion Even though WT-S are believed to carry a low risk for end-stage renal disease, in this study, a remarkable number of WT-S presented with previously unidentified subclinical signs of renal function impairment and secondary morbidity. Therefore, it is important to continue regular follow-up, especially after transition into adulthood.
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1EISSN: 1432-198X
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3PMID: 28451896
languageeng
publisherBerlin/Heidelberg: Springer Berlin Heidelberg
subjectAdolescent ; Adult ; Age determination ; Analysis ; Antineoplastic Agents - adverse effects ; Blood pressure ; Cancer Survivors - statistics & numerical data ; Care and treatment ; Chemotherapy ; Chemotherapy, Adjuvant ; Children ; Chronic kidney failure ; Cross-Sectional Studies ; Cystatin ; Diagnosis ; End-stage renal disease ; Epidermal growth factor receptors ; Excretion ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Health aspects ; Humans ; Hypertension ; Hypertrophy ; Kidney - diagnostic imaging ; Kidney - drug effects ; Kidney - physiopathology ; Kidney - surgery ; Kidney diseases ; Kidney Neoplasms - mortality ; Kidney Neoplasms - physiopathology ; Kidney Neoplasms - therapy ; Kidney transplantation ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Morbidity ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Nephroblastoma ; Nephrology ; Original Article ; Pediatrics ; Prevalence ; Prospective Studies ; Proteinuria - epidemiology ; Proteinuria - physiopathology ; Proteinuria - urine ; Radiation ; Radiation therapy ; Radiotherapy ; Renal function ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology ; Renal Insufficiency, Chronic - urine ; Risk factors ; Surgery ; Ultrasonography ; Urology ; Usage ; Wilms Tumor - mortality ; Wilms Tumor - physiopathology ; Wilms Tumor - therapy ; Young Adult
ispartofPediatric nephrology (Berlin, West), 2017, Vol.32 (10), p.1915-1925
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1Russo, Alexandra
2Wingerter, Arthur
3Alt, Francesca
4Theruvath, Johanna
5El Malki, Khalifa
6Kron, Bettina
7Dittrich, Matthias
8Lotz, Johannes
9Stein, Raimund
10Beetz, Rolf
11Faber, Joerg
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0Prospective analysis of long-term renal function in survivors of childhood Wilms tumor
1Pediatric nephrology (Berlin, West)
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0Pediatr Nephrol
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descriptionBackground Considering the improved outcome, a better understanding of the late effects in Wilms tumor survivors (WT-S) is needed. This study was aimed at evaluating renal function and determining the prevalence of clinical and subclinical renal dysfunction in a cohort of WT-S using a multimodal diagnostic approach. Methods Thirty-seven WT-S were included in this prospective cross-sectional single center study. To evaluate renal function, glomerular filtration rate (GFR) and urinary protein excretion were assessed. Additionally, kidney sonomorphology and blood pressure were analyzed. Results All examined WT-S (mean age 28.7 years, mean follow-up 24.8 years) had been treated with a combination of surgery and chemotherapy; 59.5% had received adjuvant radiotherapy. Impaired glomerular renal function was detected in a considerable proportion of WT-S, with age-adjusted cystatin-based GFR estimation below age norm in 55.9%. A lower cystatin-based estimated GFR (eGFR) correlated with longer follow-up time and higher irradiation dose. In 5 patients (13.5%) albuminuria was identified. Analysis of sonomorphology detected compensatory contralateral renal hypertrophy in 83.3% of WT-S. Chronic kidney disease (CKD) ≥ stage II was present in 55.9% of WT-S. Blood pressure measurements revealed arterial hypertension in 15 (40.5%) WT-S (newly diagnosed n =10). In 24.3% both CKD ≥ stage II and arterial hypertension were determined. Conclusion Even though WT-S are believed to carry a low risk for end-stage renal disease, in this study, a remarkable number of WT-S presented with previously unidentified subclinical signs of renal function impairment and secondary morbidity. Therefore, it is important to continue regular follow-up, especially after transition into adulthood.
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0Adolescent
1Adult
2Age determination
3Analysis
4Antineoplastic Agents - adverse effects
5Blood pressure
6Cancer Survivors - statistics & numerical data
7Care and treatment
8Chemotherapy
9Chemotherapy, Adjuvant
10Children
11Chronic kidney failure
12Cross-Sectional Studies
13Cystatin
14Diagnosis
15End-stage renal disease
16Epidermal growth factor receptors
17Excretion
18Female
19Follow-Up Studies
20Glomerular Filtration Rate
21Health aspects
22Humans
23Hypertension
24Hypertrophy
25Kidney - diagnostic imaging
26Kidney - drug effects
27Kidney - physiopathology
28Kidney - surgery
29Kidney diseases
30Kidney Neoplasms - mortality
31Kidney Neoplasms - physiopathology
32Kidney Neoplasms - therapy
33Kidney transplantation
34Male
35Medicine
36Medicine & Public Health
37Middle Aged
38Morbidity
39Nephrectomy - adverse effects
40Nephrectomy - methods
41Nephroblastoma
42Nephrology
43Original Article
44Pediatrics
45Prevalence
46Prospective Studies
47Proteinuria - epidemiology
48Proteinuria - physiopathology
49Proteinuria - urine
50Radiation
51Radiation therapy
52Radiotherapy
53Renal function
54Renal Insufficiency, Chronic - epidemiology
55Renal Insufficiency, Chronic - physiopathology
56Renal Insufficiency, Chronic - urine
57Risk factors
58Surgery
59Ultrasonography
60Urology
61Usage
62Wilms Tumor - mortality
63Wilms Tumor - physiopathology
64Wilms Tumor - therapy
65Young Adult
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titleProspective analysis of long-term renal function in survivors of childhood Wilms tumor
authorNeu, Marie A ; Russo, Alexandra ; Wingerter, Arthur ; Alt, Francesca ; Theruvath, Johanna ; El Malki, Khalifa ; Kron, Bettina ; Dittrich, Matthias ; Lotz, Johannes ; Stein, Raimund ; Beetz, Rolf ; Faber, Joerg
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0Adolescent
1Adult
2Age determination
3Analysis
4Antineoplastic Agents - adverse effects
5Blood pressure
6Cancer Survivors - statistics & numerical data
7Care and treatment
8Chemotherapy
9Chemotherapy, Adjuvant
10Children
11Chronic kidney failure
12Cross-Sectional Studies
13Cystatin
14Diagnosis
15End-stage renal disease
16Epidermal growth factor receptors
17Excretion
18Female
19Follow-Up Studies
20Glomerular Filtration Rate
21Health aspects
22Humans
23Hypertension
24Hypertrophy
25Kidney - diagnostic imaging
26Kidney - drug effects
27Kidney - physiopathology
28Kidney - surgery
29Kidney diseases
30Kidney Neoplasms - mortality
31Kidney Neoplasms - physiopathology
32Kidney Neoplasms - therapy
33Kidney transplantation
34Male
35Medicine
36Medicine & Public Health
37Middle Aged
38Morbidity
39Nephrectomy - adverse effects
40Nephrectomy - methods
41Nephroblastoma
42Nephrology
43Original Article
44Pediatrics
45Prevalence
46Prospective Studies
47Proteinuria - epidemiology
48Proteinuria - physiopathology
49Proteinuria - urine
50Radiation
51Radiation therapy
52Radiotherapy
53Renal function
54Renal Insufficiency, Chronic - epidemiology
55Renal Insufficiency, Chronic - physiopathology
56Renal Insufficiency, Chronic - urine
57Risk factors
58Surgery
59Ultrasonography
60Urology
61Usage
62Wilms Tumor - mortality
63Wilms Tumor - physiopathology
64Wilms Tumor - therapy
65Young Adult
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1Russo, Alexandra
2Wingerter, Arthur
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4Theruvath, Johanna
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6Kron, Bettina
7Dittrich, Matthias
8Lotz, Johannes
9Stein, Raimund
10Beetz, Rolf
11Faber, Joerg
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1Russo, Alexandra
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3Alt, Francesca
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7Dittrich, Matthias
8Lotz, Johannes
9Stein, Raimund
10Beetz, Rolf
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date2017-04-28
risdate2017
volume32
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pages1915-1925
issn0931-041X
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abstractBackground Considering the improved outcome, a better understanding of the late effects in Wilms tumor survivors (WT-S) is needed. This study was aimed at evaluating renal function and determining the prevalence of clinical and subclinical renal dysfunction in a cohort of WT-S using a multimodal diagnostic approach. Methods Thirty-seven WT-S were included in this prospective cross-sectional single center study. To evaluate renal function, glomerular filtration rate (GFR) and urinary protein excretion were assessed. Additionally, kidney sonomorphology and blood pressure were analyzed. Results All examined WT-S (mean age 28.7 years, mean follow-up 24.8 years) had been treated with a combination of surgery and chemotherapy; 59.5% had received adjuvant radiotherapy. Impaired glomerular renal function was detected in a considerable proportion of WT-S, with age-adjusted cystatin-based GFR estimation below age norm in 55.9%. A lower cystatin-based estimated GFR (eGFR) correlated with longer follow-up time and higher irradiation dose. In 5 patients (13.5%) albuminuria was identified. Analysis of sonomorphology detected compensatory contralateral renal hypertrophy in 83.3% of WT-S. Chronic kidney disease (CKD) ≥ stage II was present in 55.9% of WT-S. Blood pressure measurements revealed arterial hypertension in 15 (40.5%) WT-S (newly diagnosed n =10). In 24.3% both CKD ≥ stage II and arterial hypertension were determined. Conclusion Even though WT-S are believed to carry a low risk for end-stage renal disease, in this study, a remarkable number of WT-S presented with previously unidentified subclinical signs of renal function impairment and secondary morbidity. Therefore, it is important to continue regular follow-up, especially after transition into adulthood.
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid28451896
doi10.1007/s00467-017-3673-9