Acute Kidney Injury in Pediatric Cancer Patients

Park, Peong Gang; Hong, Che Ry; Kang, Eunjeong; Park, Minsu; Lee, Hajeong; Kang, Hyoung Jin; Shin, Hee Young; Ha, Il Soo; Cheong, Hae Il; Yoon, Hyung Jin; Kang, Hee Gyung

doi:10.1016/j.jpeds.2018.12.023

Cited by 35 publications

(30 citation statements)

References 31 publications

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“…For osteosarcoma, treatment consists of methotrexate, doxorubicin and cisplatin [ 16 ]. Nephrotoxicity caused by methotrexate is reversible [ 18 , 19 , 45 , 46 ]. Hence, long-term toxicity is most likely caused by cisplatin.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Tubular Dysfunction in Childhood Cancer Survivors; DCCSS-LATER 2 Renal Study

Kooijmans

Pal

Pluijm

et al. 2022

Cancers

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The aim of this nationwide cross-sectional cohort study was to determine the prevalence of and risk factors for tubular dysfunction in childhood cancer survivors (CCS). In the DCCSS-LATER 2 Renal study, 1024 CCS (≥5 years after diagnosis), aged ≥ 18 years at study, treated between 1963 and 2001 with potentially nephrotoxic therapy (i.e., nephrectomy, abdominal radiotherapy, total body irradiation, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide, or hematopoietic stem cell transplantation) participated, and 500 age- and sex-matched participants from Lifelines acted as controls. Tubular electrolyte loss was defined as low serum levels (magnesium < 0.7 mmol/L, phosphate < 0.7 mmol/L and potassium < 3.6 mmol/L) with increased renal excretion or supplementation. A α1-microglobulin:creatinine ratio > 1.7 mg/mmol was considered as low-molecular weight proteinuria (LMWP). Multivariable risk analyses were performed. After median 25.5 years follow-up, overall prevalence of electrolyte losses in CCS (magnesium 5.6%, potassium 4.5%, phosphate 5.5%) was not higher compared to controls. LMWP was more prevalent (CCS 20.1% versus controls 0.4%). LMWP and magnesium loss were associated with glomerular dysfunction. Ifosfamide was associated with potassium loss, phosphate loss (with cumulative dose > 42 g/m2) and LMWP. Cisplatin was associated with magnesium loss and a cumulative dose > 500 mg/m2 with potassium and phosphate loss. Carboplatin cumulative dose > 2800 mg/m2 was associated with potassium loss. In conclusion, long-term tubular dysfunction is infrequent. Yet, ifosfamide, cisplatin and carboplatin are risk factors.

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Section: Discussionmentioning

confidence: 99%

Long-Term Tubular Dysfunction in Childhood Cancer Survivors; DCCSS-LATER 2 Renal Study

Kooijmans

Pal

Pluijm

et al. 2022

Cancers

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“…Available studies suggest that, apart from oncological surgery, nephrotoxic chemotherapy and germline predisposition contribute to this ESKD [ 14 , 72 ]. Awareness, prevention and monitoring of impaired kidney function already during the early treatment phase is important, since AKI is described to be associated with the development of long-term kidney failure in pediatric cancer patients [ 9 ]. In order to prevent ESKD or impaired kidney function, recommendations as defined in the ExPO-r-Net initiative, include consultation by, and/or referral to a dedicated experienced tertiary center, especially for surgery [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Whereas survival rates of patients with unilateral Wilms tumor are high, survival of patients with bilateral Wilms tumors seems highly variable, ranging from 43–91% [ 3 , 7 , 8 ]. Long-term outcomes are expected to be even less favorable, based on tumor behavior, but also due to disease- and treatment-related kidney disease with its subsequent comorbidity and corresponding lower life expectancy [ 9 , 10 , 11 , 12 , 13 ]. In addition, patients with bilateral renal tumors more frequently carry underlying genetic predisposition than patients with unilateral tumors [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Bilateral Renal Tumors in Children: The First 5 Years’ Experience of National Centralization in The Netherlands and a Narrative Review of the Literature

Peer

Hol

Steeg

et al. 2021

JCM

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Survival of unilateral Wilms tumors (WTs) is exceeding 90%, whereas bilateral WTs have an inferior outcome. We evaluated all Dutch patients with bilateral kidney tumors, treated in the first five years of national centralization and reviewed relevant literature. We identified 24 patients in our center (2015–2020), 23 patients had WT/nephroblastomatosis and one renal cell carcinoma. Patients were treated according to SIOP-RTSG protocols. Chemotherapy response was observed in 26/34 WTs. Nephroblastomatosis lesions were stable (n = 7) or showed response (n = 18). Nephron-sparing surgery was performed in 11/22 patients undergoing surgery (n = 2 kidneys positive margins). Local stage in 20 patients with ≥1 WT revealed stage I (n = 7), II (n = 4) and III (n = 9). Histology was intermediate risk in 15 patients and high risk in 5. Three patients developed a WT in a treated nephroblastomatosis lesion. Two of 24 patients died following toxicity and renal failure, i.e., respectively dialysis-related invasive fungal infection and septic shock. Genetic predisposition was confirmed in 18/24 patients. Our literature review revealed that knowledge is scarce on bilateral renal tumor patients with metastases and that radiotherapy seems important for local stage III patients. Bilateral renal tumors are a therapeutic challenge. We describe management and outcome in a national expert center and summarized available literature, serving as baseline for further improvement of care.

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“…In our previous studies, we reported an unexpectedly higher incidence of AKI in lung cancer patients than other malignancies [13][14][15]. Therefore, in the present study, we aimed to determine the clinical significance of AKI in lung cancer patients with a focus on the impact on both patient and kidney prognosis.…”

Section: Introductionmentioning

confidence: 87%

Clinical Significance of Acute Kidney Injury in Lung Cancer Patients

et al. 2021

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Acute kidney injury (AKI) in cancer patients is associated with increased morbidity and mortality. The incidence of AKI in lung cancer seems to be relatively higher compared with other solid organ malignancies, although its impact on patient outcomes remains unclear. Materials and MethodsThe patients newly diagnosed with lung cancer from 2004 to 2013 were enrolled in this retrospective cohort study. The patients were categorized according to the presence and severity of AKI. We compared all-cause mortality and long-term renal outcome according to AKI stage. ResultsA total of 3,202 patients were included in the final analysis. AKI occurred in 1,783 (55.7%) patients during the follow-up period, with the majority having mild AKI stage 1 (75.8%).During the follow-up of 2.6 ± 2.18 years, total 1,251 (53.7%) patients were died and 5-yr survival rate was 46.9%. We found that both AKI development and severity were independent risk factors for all-cause mortality in lung cancer patients, even after adjustment for lung cancerspecific variables including the stage or pathological type. In addition, patients suffered from more severe AKI tend to encounter de novo CKD development, worsening kidney function, and end-stage kidney disease progression. ConclusionIn this study, more than half of the lung cancer patients experienced AKI during their diagnosis and treatment period. Moreover, AKI occurrence and more advanced AKI were associated with a higher mortality risk and adverse kidney outcomes.

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Acute Kidney Injury in Pediatric Cancer Patients

Cited by 35 publications

References 31 publications

Long-Term Tubular Dysfunction in Childhood Cancer Survivors; DCCSS-LATER 2 Renal Study

Long-Term Tubular Dysfunction in Childhood Cancer Survivors; DCCSS-LATER 2 Renal Study

Bilateral Renal Tumors in Children: The First 5 Years’ Experience of National Centralization in The Netherlands and a Narrative Review of the Literature

Clinical Significance of Acute Kidney Injury in Lung Cancer Patients

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