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Somatic growth and renal function after unilateral nephrectomy for Wilms' tumor
M Srinivas1, S Agarwala, A K Padhy
1Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
Pediatric Surgery International
|January 9, 1999
Summary
Children treated for Wilms' tumor with a solitary kidney show normal growth but often develop microalbuminuria, indicating hyperfiltration injury. Close renal function monitoring is crucial for these patients.
Area of Science:
- Pediatric Nephrology
- Oncology
- Renal Physiology
Background:
- Solitary kidneys, common after unilateral nephrectomy for Wilms' tumor, are susceptible to hyperfiltration injury.
- Hyperfiltration may impact long-term renal health in survivors.
Purpose of the Study:
- To assess somatic growth and development in children post-Wilms' tumor treatment.
- To evaluate renal function and detect injury in the remaining kidney of these patients.
Main Methods:
- Longitudinal follow-up of pediatric patients treated for Wilms' tumor.
- Assessment of somatic growth, development, DTPA (diethylenetriaminepentaacetic acid) clearance, and microalbuminuria via 24-hour urine collection.
Main Results:
- All evaluated children exhibited normal somatic growth and development.
- DTPA clearance was within normal limits for the cohort.
- Microalbuminuria was detected in 84% of patients, suggesting hyperfiltration injury.
Conclusions:
- Despite normal growth and DTPA clearance, microalbuminuria indicates subclinical renal injury in long-term Wilms' tumor survivors with a solitary kidney.
- Enhanced monitoring of renal function, specifically for signs of hyperfiltration injury, is recommended alongside routine tumor surveillance.