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Hypertension in Wilms tumor
Wendy Hsiao1, Michelle Denburg2, Benjamin Laskin2
1Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. hsiaow@chop.edu.
Pediatric Nephrology (Berlin, Germany)
|May 13, 2023
Summary
Wilms tumor survivors face long-term hypertension risks due to kidney damage and treatments. Ambulatory blood pressure monitoring may improve diagnosis of masked hypertension in these pediatric cancer patients.
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.
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