Late effects on renal glomerular and tubular function in childhood cancer survivors.
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.
Bárdi
Edit
E
Department of Pediatrics, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. editbardi@hotmail.com
Oláh
Anna V
AV
Bartyik
Katalin
K
Endreffy
Emoke
E
Jenei
Csaba
C
Kappelmayer
János
J
Kiss
Csongor
C
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
C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins; D003404:Creatinine; C488034:ACE protein, human; D007703:Peptidyl-Dipeptidase A