BACKGROUND: Impaired glomerular function is one of the health problems affecting childhood cancer survivors (CCS). It is unclear whether glomerular function deteriorates or recovers. We investigated time trends and predictors of glomerular function in CCS. METHODS: We evaluated repeated observations of estimated glomerular filtration rate (GFR) and glomerular dysfunction (GFR <90 mL/min/1.73 m(2)) among adult five-year CCS treated in the EKZ/AMC between 1966 and 2003. Ifosfamide, cisplatin, carboplatin, high-dose (HD) methotrexate, HD-cyclophosphamide, radiotherapy to the kidney region, and nephrectomy (i.e., potentially nephrotoxic therapy) were investigated as predictors of glomerular function patterns over time in multivariable longitudinal analyses. RESULTS: At a median follow-up of 21 years after diagnosis, glomerular function was assessed in 1,122 CCS aged ≥18 years. CCS treated with potentially nephrotoxic therapy had a significantly lower GFR and higher glomerular dysfunction probability up to 35 years after cancer diagnosis compared with CCS treated without nephrotoxic therapy (P < 0.001). Especially ifosfamide, cisplatin, and nephrectomy were associated with worse glomerular function that persisted during the entire follow-up period (P < 0.001). Glomerular function deteriorated over time in all CCS (P < 0.001). CCS treated with higher doses of cisplatin seem to have a higher deterioration rate as compared with other CCS (P < 0.005). CONCLUSIONS: The loss in glomerular function starts early, especially for CCS treated with ifosfamide, higher doses of cisplatin, and nephrectomy, and seems to be persistent. We have an indication that CCS treated with higher doses of cisplatin experience faster decline than other CCS. IMPACT: As glomerular function continues to deteriorate, CCS are at risk for premature chronic renal failure.
BACKGROUND: Impaired glomerular function is one of the health problems affecting childhood cancer survivors (CCS). It is unclear whether glomerular function deteriorates or recovers. We investigated time trends and predictors of glomerular function in CCS. METHODS: We evaluated repeated observations of estimated glomerular filtration rate (GFR) and glomerular dysfunction (GFR <90 mL/min/1.73 m(2)) among adult five-year CCS treated in the EKZ/AMC between 1966 and 2003. Ifosfamide, cisplatin, carboplatin, high-dose (HD) methotrexate, HD-cyclophosphamide, radiotherapy to the kidney region, and nephrectomy (i.e., potentially nephrotoxic therapy) were investigated as predictors of glomerular function patterns over time in multivariable longitudinal analyses. RESULTS: At a median follow-up of 21 years after diagnosis, glomerular function was assessed in 1,122 CCS aged ≥18 years. CCS treated with potentially nephrotoxic therapy had a significantly lower GFR and higher glomerular dysfunction probability up to 35 years after cancer diagnosis compared with CCS treated without nephrotoxic therapy (P < 0.001). Especially ifosfamide, cisplatin, and nephrectomy were associated with worse glomerular function that persisted during the entire follow-up period (P < 0.001). Glomerular function deteriorated over time in all CCS (P < 0.001). CCS treated with higher doses of cisplatin seem to have a higher deterioration rate as compared with other CCS (P < 0.005). CONCLUSIONS: The loss in glomerular function starts early, especially for CCS treated with ifosfamide, higher doses of cisplatin, and nephrectomy, and seems to be persistent. We have an indication that CCS treated with higher doses of cisplatin experience faster decline than other CCS. IMPACT: As glomerular function continues to deteriorate, CCS are at risk for premature chronic renal failure.
Authors: Irene Isabel P Lim; Debra A Goldman; Benjamin A Farber; Jennifer M Murphy; Sara J Abramson; Ellen Basu; Stephen Roberts; Michael P LaQuaglia; Anita P Price Journal: J Pediatr Surg Date: 2016-03-02 Impact factor: 2.545
Authors: Bryan V Dieffenbach; Qi Liu; Andrew J Murphy; Deborah R Stein; Natalie Wu; Arin L Madenci; Wendy M Leisenring; Nina S Kadan-Lottick; Emily R Christison-Lagay; Robert E Goldsby; Rebecca M Howell; Susan A Smith; Kevin C Oeffinger; Yutaka Yasui; Gregory T Armstrong; Christopher B Weldon; Eric J Chow; Brent R Weil Journal: Eur J Cancer Date: 2021-08-11 Impact factor: 10.002
Authors: Kelly R McMahon; Asaf Lebel; Shahrad Rod Rassekh; Kirk R Schultz; Tom D Blydt-Hansen; Geoffrey D E Cuvelier; Cherry Mammen; Maury Pinsk; Bruce C Carleton; Ross T Tsuyuki; Colin J D Ross; Louis Huynh; Mariya Yordanova; Frédérik Crépeau-Hubert; Stella Wang; Ana Palijan; Jasmine Lee; Debbie Boyko; Michael Zappitelli Journal: Pediatr Nephrol Date: 2022-10-19 Impact factor: 3.651
Authors: Marc Ghannoum; Darren M Roberts; David S Goldfarb; Jesper Heldrup; Kurt Anseeuw; Tais F Galvao; Thomas D Nolin; Robert S Hoffman; Valery Lavergne; Paul Meyers; Sophie Gosselin; Tudor Botnaru; Karine Mardini; David M Wood Journal: Clin J Am Soc Nephrol Date: 2022-03-02 Impact factor: 10.614
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