Evaluation of Pediatric and Young Adult Cancer Survivors at Risk of Long-Term Kidney Complications

Nephrotoxic chemotherapy, nephrectomy, abdominal radiotherapy exposure, and the presence of kidney or pelvic tumors are risk factors associated with long-term kidney complications. This study aimed to determine the prevalence of long-term kidney complications in patients who survived pediatric and young adult cancer and were exposed to those risk factors in the current anticancer treatment era.

This retrospective study included patients who survived pediatric and young adult cancer and received nephrotoxic chemotherapy, nephrectomy, abdominal radiotherapy, and/or had kidney or pelvic tumors. Patients were under follow-up at Nationwide Children's Hospital pediatric cancer survivors' clinic between January 1, 2016 and December 31, 2021.

A total of 109 patients met inclusion criteria. Long-term kidney complications included low glomerular filtration rate (GFR) (11.9%), hyperfiltration (22.9%), and hypertension (49.5%). Risk factors associated with low GFR included surviving childhood solid tumors, nephrectomy, carboplatin, and ifosfamide treatments. Urinalysis was available in 64 patients (58.7%), and of those, five had proteinuria-associated long-term kidney complications.

Long-term kidney complications are prevalent in patients who survived pediatric and young adult solid tumors. Current guidelines do not recommend evaluation of urinalysis or albuminuria in patients at risk of long-term kidney complications, which can significantly impact their treatment.