title: Late effects on renal glomerular and tubular function in childhood cancer survivors.
abstract: BACKGROUND
  Late nephrotoxicity among childhood cancer survivors is poorly documented.
  
  
  METHODS
  We investigated 115 patients and 86 controls assessing serum cystatin C concentration (CysC), urinary N-acetyl-beta-D-glucosaminidase activity (NAG), and microalbuminuria. Proteinuria was quantified and electrophoresis performed. Polymorphism of the angiotensin convertase enzyme (ACE) gene was determined by genomic PCR.
  
  
  RESULTS
  CysC was elevated in Wilms tumor (WT) patients. Gross proteinuria was observed in 30 patients including three patients with progressive proteinuria who improved on ACE-inhibitor treatment. Neither patients with proteinuria nor the entire study population differed from controls with respect to ACE polymorphism. Pathologically elevated urinary NAG was noted in 38% of leukemia/lymphoma, 54% of solid tumor, 20% of WT survivors. A similar distribution of pathological microalbuminuria was found.
  
  
  CONCLUSIONS
  Mild-to-moderate subclinical glomerular and tubular damage can be identified in many childhood cancer survivors. However, most patients experience some spontaneous recovery from acute nephrotoxicity.
authors.affiliation: Department of Pediatrics, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. editbardi@hotmail.com
authors.forename: Edit
authors.initials: E
authors.lastname: Bárdi
authors.forename: Anna V
authors.initials: AV
authors.lastname: Oláh
authors.forename: Katalin
authors.initials: K
authors.lastname: Bartyik
authors.forename: Emoke
authors.initials: E
authors.lastname: Endreffy
authors.forename: Csaba
authors.initials: C
authors.lastname: Jenei
authors.forename: János
authors.initials: J
authors.lastname: Kappelmayer
authors.forename: Csongor
authors.initials: C
authors.lastname: Kiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000652:urine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007677:Kidney Function Tests; D007678:Kidney Glomerulus / Q000187:drug effects* / Q000473:pathology / Q000502:physiology / Q000503:physiopathology*; D007684:Kidney Tubules / Q000187:drug effects* / Q000473:pathology / Q000502:physiology / Q000503:physiopathology*; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D007703:Peptidyl-Dipeptidase A / Q000235:genetics; D011110:Polymorphism, Genetic / Q000235:genetics; D017741:Survivors; D013997:Time Factors
chemical_list: C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D003404:Creatinine; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A