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[The kidney in children under chemotherapy]
1Service de pédiatrie, CHUV, Lausanne.
Revue Medicale De La Suisse Romande
|December 1, 1996
Summary
Pediatric cancer survivors may experience long-term kidney damage from chemotherapy. Pediatricians must monitor renal function in children undergoing treatment for potential nephrotoxic side-effects.
Area of Science:
- Pediatric Oncology
- Nephrology
- Toxicology
Context:
- Increasing survival rates in childhood cancer patients treated with intensive chemotherapy.
- Chemotherapy can lead to significant long-term adverse effects, including secondary cancers and organ damage.
- Renal side-effects are a notable complication of certain chemotherapeutic agents.
Purpose:
- To highlight the occurrence and types of renal toxicities following pediatric chemotherapy.
- To inform pediatricians about the specific chemotherapeutic agents associated with nephrotoxicity.
- To emphasize the importance of vigilant renal function monitoring in these patients.
Summary:
- Chemotherapy for pediatric cancers can cause both tubular and glomerular kidney damage.
- Agents like cisplatinum and ifosfamide are particularly nephrotoxic, while carboplatin and cyclophosphamide are less so.
- Observed renal effects include metabolic acidosis, hypokalemia, hypomagnesemia, proteinuria, Fanconi syndrome, rickets, and decreased glomerular filtration rate (GFR).
Impact:
- Enhances awareness among pediatricians regarding potential chemotherapy-induced kidney damage.
- Promotes proactive monitoring and management of renal function in pediatric cancer patients.
- Aims to mitigate long-term renal sequelae and improve the quality of life for childhood cancer survivors.