Hypertension in Wilms tumor

Area of Science:

• Pediatric Oncology
• Nephrology
• Cardiology

Background:

• Wilms tumor (WT) is the most common pediatric kidney cancer.
• Hypertension is a common acute presentation and long-term risk for WT survivors.
• Factors contributing to hypertension include nephron loss, radiation, and chemotherapy.

Purpose of the Study:

• To review current literature on hypertension in Wilms tumor diagnosis and survivorship.
• To highlight the role of ambulatory blood pressure monitoring (ABPM) in detecting masked hypertension.
• To identify gaps in understanding cardiovascular and kidney outcomes in WT survivors.

Main Methods:

• Literature review of studies on Wilms tumor and hypertension.
• Analysis of data on acute and long-term hypertension in WT patients.
• Evaluation of ABPM utility in WT survivor screening.

Main Results:

• Children with WT frequently present with acute hypertension, often resolving post-nephrectomy.
• WT survivors have a significantly increased risk of long-term hypertension.
• Masked hypertension is prevalent in WT survivors, potentially undiagnosed by casual BP measurements.

Conclusions:

• Routine ABPM screening may benefit select Wilms tumor survivors for early hypertension detection.
• Further research is needed on the correlation of BP parameters with cardiac and kidney outcomes.
• Longitudinal studies are crucial for optimizing hypertension management and improving long-term health in WT survivors.