Ronit Calderon-Margalit1, Oren Pleniceanu2,3,4, Dorit Tzur3, Michal Stern-Zimmer5, Arnon Afek2,6, Tomer Erlich2,3,7, Guy Verhovsky3,8,9, Lital Keinan-Boker10,11, Karl Skorecki12,13, Gilad Twig3,14,15,16, Asaf Vivante17,5,14. 1. Hadassah-Hebrew University Braun School of Public Health, Jerusalem, Israel ronitcm@gmail.com asafvivante@gmail.com asaf.vivante@sheba.health.gov.il. 2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 3. Department of Military Medicine, Hebrew University of Jerusalem, Jerusalem and the Israel Defense Forces Medical Corps, Ramat Gan, Israel. 4. The Kidney Research Institute, Sheba Medical Center, Tel Hashomer, Israel. 5. Department of Pediatrics B and Pediatric Nephrology Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel. 6. Central Management, Chaim Sheba Medical Center, Tel Hashomer, Israel. 7. Department of Urology, Sheba Medical Center, Ramat Gan, Israel. 8. Department of Urology, Shamir (Assaf Harofeh) Medical Center, Zerifin, Israel. 9. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. 10. Israel Center for Disease Control, Ministry of Health, Tel Hashomer, Israel. 11. School of Public Health, University of Haifa, Haifa, Israel. 12. Department of Nephrology, Rambam Health Care Campus and the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 13. Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel. 14. Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel. 15. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 16. Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel. 17. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel ronitcm@gmail.com asafvivante@gmail.com asaf.vivante@sheba.health.gov.il.
Abstract
BACKGROUND: Increasing cancer incidence among children alongside improved treatments has resulted in a growing number of pediatric cancer survivors. Despite childhood cancer survivors' exposure to various factors that compromise kidney function, few studies have investigated the association between childhood cancer and future kidney disease. METHODS: To assess the risk of ESKD among childhood cancer survivors, we conducted a nationwide, population-based, retrospective cohort study that encompassed all Israeli adolescents evaluated for mandatory military service from 1967 to 1997. After obtaining detailed histories, we divided the cohort into three groups: participants without a history of tumors, those with a history of a benign tumor (nonmalignant tumor with functional impairment), and those with a history of malignancy (excluding kidney cancer). This database was linked to the Israeli ESKD registry to identify incident ESKD cases. We used Cox proportional hazards models to estimate the hazard ratio (HR) of ESKD. RESULTS: Of the 1,468,600 participants in the cohort, 1,444,345 had no history of tumors, 23,282 had a history of a benign tumor, and 973 had a history of malignancy. During a mean follow-up of 30.3 years, 2416 (0.2%) participants without a history of tumors developed ESKD. Although a history of benign tumors was not associated with an increased ESKD risk, participants with a history of malignancy exhibited a substantially elevated risk for ESKD compared with participants lacking a history of tumors, after controlling for age, sex, enrollment period, and paternal origin (adjusted HR, 3.2; 95% confidence interval, 1.3 to 7.7). CONCLUSIONS: Childhood cancer is associated with an increased risk for ESKD, suggesting the need for tighter and longer nephrological follow-up.
BACKGROUND: Increasing cancer incidence among children alongside improved treatments has resulted in a growing number of pediatric cancer survivors. Despite childhood cancer survivors' exposure to various factors that compromise kidney function, few studies have investigated the association between childhood cancer and future kidney disease. METHODS: To assess the risk of ESKD among childhood cancer survivors, we conducted a nationwide, population-based, retrospective cohort study that encompassed all Israeli adolescents evaluated for mandatory military service from 1967 to 1997. After obtaining detailed histories, we divided the cohort into three groups: participants without a history of tumors, those with a history of a benign tumor (nonmalignant tumor with functional impairment), and those with a history of malignancy (excluding kidney cancer). This database was linked to the Israeli ESKD registry to identify incident ESKD cases. We used Cox proportional hazards models to estimate the hazard ratio (HR) of ESKD. RESULTS: Of the 1,468,600 participants in the cohort, 1,444,345 had no history of tumors, 23,282 had a history of a benign tumor, and 973 had a history of malignancy. During a mean follow-up of 30.3 years, 2416 (0.2%) participants without a history of tumors developed ESKD. Although a history of benign tumors was not associated with an increased ESKD risk, participants with a history of malignancy exhibited a substantially elevated risk for ESKD compared with participants lacking a history of tumors, after controlling for age, sex, enrollment period, and paternal origin (adjusted HR, 3.2; 95% confidence interval, 1.3 to 7.7). CONCLUSIONS: Childhood cancer is associated with an increased risk for ESKD, suggesting the need for tighter and longer nephrological follow-up.
Authors: Abdullahi Mudi; Cecil Steven Levy; Jennifer Ann Geel; Janet Elizabeth Poole Journal: Pediatr Blood Cancer Date: 2016-07-09 Impact factor: 3.167
Authors: Lillian R Meacham; Eric J Chow; Kirsten K Ness; Kala Y Kamdar; Yan Chen; Yutaka Yasui; Kevin C Oeffinger; Charles A Sklar; Leslie L Robison; Ann C Mertens Journal: Cancer Epidemiol Biomarkers Prev Date: 2010-01 Impact factor: 4.254
Authors: Melissa M Hudson; Kirsten K Ness; James G Gurney; Daniel A Mulrooney; Wassim Chemaitilly; Kevin R Krull; Daniel M Green; Gregory T Armstrong; Kerri A Nottage; Kendra E Jones; Charles A Sklar; Deo Kumar Srivastava; Leslie L Robison Journal: JAMA Date: 2013-06-12 Impact factor: 56.272