BACKGROUND: Mild-to-moderate renal function loss may be an independent risk factor for cardiovascular disease and overall mortality. As in adults with renal carcinoma nephrectomy is associated with an high risk for moderate renal function loss, we aimed to assess the renal function adaptation over a long period of time in children with unilateral renal tumor (URT). PROCEDURE: Seventy-two children who underwent surgery for URT were enrolled in this study. Glomerular filtration rate was estimated (eGFR) with the Modification of Diet in Renal Study or the Schwartz equation, as appropriate for the age. RESULTS: Twelve patients treated by nephron-sparing surgery (Group A) and 42 treated by nephrectomy (Group B) had an age between 2 and 30 years; 18 patients treated by nephrectomy had an age between 33 and 51 years (Group C). At cross-sectional follow-up 8% patients of Group A, 42% of Group B and 78% of Group C presented a mild-to-moderate renal function. The longitudinal data stratified by post-operative intervals showed that patients of Group C presented a significant progressive decrease in mean ± standard deviation eGFR (88.1 ± 22.6 during the third decade after surgery vs. 66.6 ± 15.6 ml/min/1.73 m(2) during the fifth decade after surgery; P = 0.02). The longitudinal data stratified by age showed that patients with an age between 45 and 54 years presented a mean eGFR significantly lower than that expected for the physiological renal function decline with aging (P = 0.001). CONCLUSION: Aging is associated with a mild-to-moderate renal function loss in many adult patients following nephrectomy during childhood for URT.
BACKGROUND: Mild-to-moderate renal function loss may be an independent risk factor for cardiovascular disease and overall mortality. As in adults with renal carcinoma nephrectomy is associated with an high risk for moderate renal function loss, we aimed to assess the renal function adaptation over a long period of time in children with unilateral renal tumor (URT). PROCEDURE: Seventy-two children who underwent surgery for URT were enrolled in this study. Glomerular filtration rate was estimated (eGFR) with the Modification of Diet in Renal Study or the Schwartz equation, as appropriate for the age. RESULTS: Twelve patients treated by nephron-sparing surgery (Group A) and 42 treated by nephrectomy (Group B) had an age between 2 and 30 years; 18 patients treated by nephrectomy had an age between 33 and 51 years (Group C). At cross-sectional follow-up 8% patients of Group A, 42% of Group B and 78% of Group C presented a mild-to-moderate renal function. The longitudinal data stratified by post-operative intervals showed that patients of Group C presented a significant progressive decrease in mean ± standard deviation eGFR (88.1 ± 22.6 during the third decade after surgery vs. 66.6 ± 15.6 ml/min/1.73 m(2) during the fifth decade after surgery; P = 0.02). The longitudinal data stratified by age showed that patients with an age between 45 and 54 years presented a mean eGFR significantly lower than that expected for the physiological renal function decline with aging (P = 0.001). CONCLUSION: Aging is associated with a mild-to-moderate renal function loss in many adult patients following nephrectomy during childhood for URT.
Authors: M Hassan Alkazemi; Zachary R Dionise; Ruiyang Jiang; Steven Wolf; Gina-Maria Pomann; Elisabeth T Tracy; Henry E Rice; Jonathan C Routh Journal: J Pediatr Surg Date: 2019-05-31 Impact factor: 2.545
Authors: Marie A Neu; Alexandra Russo; Arthur Wingerter; Francesca Alt; Johanna Theruvath; Khalifa El Malki; Bettina Kron; Matthias Dittrich; Johannes Lotz; Raimund Stein; Rolf Beetz; Joerg Faber Journal: Pediatr Nephrol Date: 2017-04-28 Impact factor: 3.714
Authors: Esmee Cm Kooijmans; Arend Bökenkamp; Nic S Tjahjadi; Jesse M Tettero; Eline van Dulmen-den Broeder; Helena Jh van der Pal; Margreet A Veening Journal: Cochrane Database Syst Rev Date: 2019-03-11
Authors: Annelies M C Mavinkurve-Groothuis; Frank van de Kracht; Rik Westland; Joanna A E van Wijk; Jacqueline J Loonen; Michiel F Schreuder Journal: Pediatr Nephrol Date: 2015-10-19 Impact factor: 3.714