Peong Gang Park1, Che Ry Hong2, Eunjeong Kang3, Minsu Park4, Hajeong Lee5, Hyoung Jin Kang2, Hee Young Shin2, Il-Soo Ha6, Hae Il Cheong6, Hyung Jin Yoon7, Hee Gyung Kang8. 1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. 2. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; Seoul National University Cancer Research Institute, Seoul, Korea. 3. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. 4. Statistics and Data Center, Samsung Medical Center, Seoul, Korea. 5. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea; Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea. 6. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; Kidney Research Institute, Seoul National University College of Medicine, Seoul, Korea. 7. Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea. 8. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. Electronic address: kanghg@snu.ac.kr.
Abstract
OBJECTIVE: To analyze the incidence of acute kidney injury (AKI) in the first year after cancer diagnosis in children and to evaluate the short-term and long-term effects on renal function and proteinuria. STUDY DESIGN: Retrospective review of medical records was done on children who were diagnosed and treated for cancer at Seoul National University Hospital between 2004 and 2013. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria. Impaired renal function of estimated glomerular filtration rate less than 90 mL/minute/1.73 m2 and development of proteinuria of cancer survivors were also assessed. RESULTS: This study included 1868 patients who were diagnosed with cancer at a median age of 7.9 years. During the course of treatment, 983 patients (52.6%) developed 1864 episodes of AKI, and the cumulative incidence at 2 weeks, 3 months, and 1 year after diagnosis was 28.9%, 39.6%, and 53.6%, respectively. The 1-year cumulative incidence was the highest in patients with acute myeloid leukemias (88.4%). In all, 6.1% of patients had more than 4 episodes of AKI and 11.8% of patients had stage 3 AKI. Among the 1096 childhood cancer survivors, 22.6% were found to have impaired renal function. A greater number of AKI episodes (≥4 times) and nephrectomy were independent risk factors of impaired renal function. Also, 8.2% of the survivors developed proteinuria among 742 childhood cancer survivors. CONCLUSIONS: A large percentage of children with cancer experience AKI during the course of treatment, and AKI is associated with impaired long-term renal function.
OBJECTIVE: To analyze the incidence of acute kidney injury (AKI) in the first year after cancer diagnosis in children and to evaluate the short-term and long-term effects on renal function and proteinuria. STUDY DESIGN: Retrospective review of medical records was done on children who were diagnosed and treated for cancer at Seoul National University Hospital between 2004 and 2013. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria. Impaired renal function of estimated glomerular filtration rate less than 90 mL/minute/1.73 m2 and development of proteinuria of cancer survivors were also assessed. RESULTS: This study included 1868 patients who were diagnosed with cancer at a median age of 7.9 years. During the course of treatment, 983 patients (52.6%) developed 1864 episodes of AKI, and the cumulative incidence at 2 weeks, 3 months, and 1 year after diagnosis was 28.9%, 39.6%, and 53.6%, respectively. The 1-year cumulative incidence was the highest in patients with acute myeloid leukemias (88.4%). In all, 6.1% of patients had more than 4 episodes of AKI and 11.8% of patients had stage 3 AKI. Among the 1096 childhood cancer survivors, 22.6% were found to have impaired renal function. A greater number of AKI episodes (≥4 times) and nephrectomy were independent risk factors of impaired renal function. Also, 8.2% of the survivors developed proteinuria among 742 childhood cancer survivors. CONCLUSIONS: A large percentage of children with cancer experience AKI during the course of treatment, and AKI is associated with impaired long-term renal function.
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Authors: Sophie E van Peer; Janna A Hol; Alida F W van der Steeg; Martine van Grotel; Godelieve A M Tytgat; Annelies M C Mavinkurve-Groothuis; Geert O R Janssens; Annemieke S Littooij; Ronald R de Krijger; Marjolijn C J Jongmans; Marc R Lilien; Jarno Drost; Roland P Kuiper; Harm van Tinteren; Marc H W A Wijnen; Marry M van den Heuvel-Eibrink Journal: J Clin Med Date: 2021-11-26 Impact factor: 4.241
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