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Long-Term Kidney Outcomes in Paediatric Osteosarcoma Survivors: A 20-Year Multi-Centre Study
Christy Yuen-Kwan Mak1, Dennis Tak-Loi Ku1, Anthony Pak-Yin Liu1,2,3
1Haematology and Oncology Centre, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong SAR, China.
Cancers
|May 13, 2026
Summary
Paediatric osteosarcoma survivors frequently develop chronic kidney disease (CKD) due to nephrotoxic chemotherapy. Early surveillance is crucial for managing kidney health in these patients.
Area of Science:
- Oncology
- Nephrology
- Pediatrics
Background:
- Long-term kidney outcomes in pediatric osteosarcoma survivors treated with nephrotoxic agents are poorly understood.
- Chemotherapy regimens for osteosarcoma often include agents with known kidney toxicity.
Purpose of the Study:
- To investigate the prevalence and risk factors of chronic kidney disease (CKD) in long-term survivors of pediatric osteosarcoma.
- To define the characteristics of kidney impairment in this patient population.
Main Methods:
- A multi-center retrospective cohort study of 89 pediatric osteosarcoma survivors with >5 years survival.
- Chronic kidney disease (CKD) was defined by kidney impairment, chronic tubulopathy, or proteinuria at last follow-up.
Main Results:
- 47.2% of survivors developed CKD, most commonly CKD stage 1 (38% with chronic tubular dysfunction).
- Significant risk factors for CKD included a history of severe acute kidney injury (AKI) and exposure to aminoglycosides.
- No dose-dependent relationship was found between specific chemotherapies (cisplatin, ifosfamide, methotrexate) and CKD development.
Conclusions:
- Chronic kidney disease (CKD) is a prevalent long-term complication in pediatric osteosarcoma survivors.
- Concurrent use of multiple nephrotoxic agents may increase CKD risk.
- Regular, multi-disciplinary surveillance including kidney function, electrolytes, and proteinuria monitoring is recommended for early CKD detection and management.
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