Evaluation of Renal Function in Pediatric Patients After Treatment for Wilms’ Tumor

Abstract

Background. Wilms' tumor is the most common kidney cancer in children. Treatment consists of pre-and post-operative chemotherapy, surgery and in some cases radiotherapy. The treatment of nephroblastomas is very effective. Hence, the population of adult patients cured of this cancer in their childhood is steadily growing, generating a need for longterm health assessment, including renal function, due to the specifications of the therapy and the location of the tumor. Objectives. The aim of the study was to evaluate nephrological complications after treatment for nephroblastoma. Material and Methods. The study group consisted of 50 children treated in the Department of Pediatric Hematology, Oncology and Bone Marrow Transplantation at Wroclaw Medical University (Poland) from 2002 to 2012. An analysis of the patients' medical histories was carried out. The glomerular filtration rate estimated by the Schwartz formula (GFR by Schwartz), serum creatinine levels, urea and electrolyte concentrations; the results of urinalysis and blood pressure were assessed. Each of these analyses was performed at the time of diagnosis, at the end of therapy, as well as 6 months, one year and two years after its completion. Results. The study showed that, in most cases, implemented therapy had no significant impact on the deterioration of renal parameters in the two-year period following treatment for Wilms' tumor. However, the group of patients treated with cyclophosphamide and carboplatin required more careful monitoring, due to a higher risk of renal function deterioration. Conclusions. The study shows that the problem of nephrotoxicity after treatment for Wilms' tumor is more frequent than indicated in other studies; however, the deterioration of kidney function in most cases is not serious. Additional attention should be paid to patients treated with cyclophosphamide and carboplatin. Assessment of the early and late effects of the treatment is a key element in improving the quality of the patients' life (Adv Clin Exp Med 2015, 24, 3, 497-504).

Late Kidney Effects of Nephron-Sparing vs Radical Nephrectomy for Wilms Tumor: A Systematic Review and Meta-Analysis

“…Two additional studies were included from review of references during full-text review (from a conference abstract and a narrative review). 17,25 Ultimately, 23 articles were included for this systematic review, including 9 studies investigating unilateral WT 11,13,14,17,26–30 and 14 studies investigating bilateral WT. 5,25,31–42 There was only 1 randomized intervention study comparing RN vs NSS to include in this review.…”

Wilms tumor (nephroblastoma) – clinical and genetic aspects

“…The patient's qualification to the appropriate prognostic group is based on the degree of local advancement (I-V) and a histopathological examination (LOW, INT, HR). The clinical and histopathological classification according to the SIOP (International Society of Pediatricians and Oncologists) includes five local stages (I-V) [12]. In stage I, the tumor is limited to the kidney; in stage II, it penetrates the kidney capsule and invades…”

Selective Detection of Nano-Sized Diagnostic Markers Using Au-ZnO Nanorod-Based Surface-Enhanced Raman Spectroscopy (SERS) in Ureteral Obstruction Models

“… 11 A general clinical indicator of kidney function is the glomerular filtration rate (GFR), with filtration function evaluated by detecting markers such as creatinine, β 2 -microglobulin (β 2 -MG), and blood urea nitrogen (BUN). 14 , 15 However, this does not accurately reflect kidney function, and it is a method that can be applied at a stage where the kidney has already been damaged or even after function has been completely lost; thus, a diagnostic technology that is capable of early diagnosis is required. When constructing an animal model to test diagnosis in the early stages of kidney damage, the extent of the ureteral obstruction can be modified to generate different degrees of kidney function loss.…”