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  • Adverse kidney...

Adverse kidney outcomes common in wilms Tumor survivors, Finds study

Dr. Nandita MohanWritten by Dr. Nandita Mohan Published On 2021-04-01T07:30:56+05:30  |  Updated On 2021-04-01T07:31:23+05:30
Adverse kidney outcomes common in wilms Tumor survivors, Finds study

Researchers from the Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL have recently observed that in survivors of Wilms Tumor, adverse kidney outcomes were common and should be closely monitored, as published in the Journal of Pediatrics. David I. Chu and colleagues conducted this prospective cohort study with the sole objective...

Researchers from the Division of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL have recently observed that in survivors of Wilms Tumor, adverse kidney outcomes were common and should be closely monitored, as published in the Journal of Pediatrics.

David I. Chu and colleagues conducted this prospective cohort study with the sole objective to assess the prevalence of therapy-related kidney outcomes in survivors of Wilms tumor (WT).

The authors included survivors of WT who were ≥5 years old and ≥1 year from completing therapy, excluding those with preexisting hypertension, prior dialysis, or kidney transplant.

All the participants completed 24-hour ambulatory blood pressure monitoring (ABPM). Abnormal blood pressure (BP) was defined as ≥90th percentile. Masked hypertension was defined as having normal office BP and abnormal ABPM findings. Urine was analyzed for kidney injury molecule-1, interleukin-18, epidermal growth factor, albumin, and creatinine. The estimated glomerular filtration rate (eGFR) was calculated using the bedside chronic kidney disease in children equation.

Recent kidney ultrasound examinations and echocardiograms were reviewed for contralateral kidney size and left ventricular hypertrophy, respectively. Clinical follow-up data were collected for approximately 2 years after study enrollment.

The results showed that -

a. Thirty-two participants (median age, 13.6 years [IQR, 10.5-16.3 years]; 75% stage 3 or higher WT) were evaluated at a median of 8.7 years (IQR, 6.5-10.8 years) after therapy; 29 participants underwent unilateral radical nephrectomy, 2 bilateral partial nephrectomy, and 1 radical and contralateral partial nephrectomy.

b. In this cohort, 72% received kidney radiotherapy and 75% received doxorubicin. c. Recent median eGFR was 95.6 mL/min/1.73 m2 (IQR, 84.6-114.0; 11 [34%] had an eGFR of <90 mL/min/1.73 m2).

d. Abnormal ABPM results were found in 22 of 29 participants (76%), masked hypertension in 10 of 29 (34%), and microalbuminuria in 2 of 32 (6%).

e. Of the 32 participants, 22 (69%) had abnormal epidermal growth factor; few had abnormal kidney injury molecule-1 or interleukin-18.

f. Seven participants with previous unilateral nephrectomy lacked compensatory contralateral kidney hypertrophy.

g. None had left ventricular hypertrophy.

Therefore, the authors concluded that "in survivors of WT, adverse kidney outcomes were common and should be closely monitored."


Adverse kidney outcomes common Wilms Tumor survivors Journal of Pediatrics. 
Source : Journal of Pediatrics
Dr. Nandita Mohan
Dr. Nandita Mohan

    BDS, MDS( Pedodontics and Preventive Dentistry)

    Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

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