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[Long-term renal function in Wilms tumor survivors].

A Sánchez Sánchez1, O Girón Vallejo1, R Ruiz Pruneda1

  • 1Servicio de Cirugía Pediátrica. Hospital Clínico Universitario Virgen de la Arrixaca. Murcia.

Cirugia Pediatrica : Organo Oficial De La Sociedad Espanola De Cirugia Pediatrica
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Long-term follow-up of Wilms tumor survivors shows a low but significant prevalence of chronic kidney disease (CKD). Metastatic disease increases CKD risk, but renal replacement therapy was not required in this cohort.

Keywords:
Renal chronic diseaseRenal functionSurvivorsTumor

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Area of Science:

  • Pediatric Oncology
  • Nephrology

Background:

  • Wilms tumor (WT) is a common pediatric kidney cancer.
  • Long-term survival rates for WT have improved, necessitating evaluation of late effects.
  • Renal function and morbimortality are critical concerns for WT survivors.

Purpose of the Study:

  • To assess long-term renal function in non-syndromic Wilms tumor survivors.
  • To evaluate the incidence of chronic kidney disease (CKD) and associated factors.
  • To determine the long-term morbimortality, including hypertension and need for renal replacement therapy.

Main Methods:

  • Retrospective analysis of WT patients treated between 1993-2017.
  • Evaluation of mortality, glomerular filtration rate (GFR), hypertension, and renal transplant requirements.
  • CKD defined as GFR <90 ml/min/1.73 m2.

Main Results:

  • 16% of survivors developed CKD (grade I-II); no patients required renal replacement therapy or transplant.
  • Bilateral WT and radiotherapy were not significantly associated with CKD development (p>0.05).
  • Higher CKD prevalence was observed in patients with stage IV disease (40%) compared to stages I-III (11%), though not statistically significant (p=0.12).

Conclusions:

  • The prevalence of CKD in Wilms tumor survivors is low but warrants attention.
  • Metastatic disease appears to be a risk factor for developing CKD.
  • While CKD occurred, severe renal complications like the need for dialysis or transplant were absent in this cohort.