title: [Problems of nephroblastoma therapy in children with chronic renal failure--report of two cases].
abstract: Chronic renal failure (CRF) in children with nephroblastoma occurs in less than 4% of cases. THE AIM of the study was to present the diagnostic and therapeutic difficulties in two children with nephroblastoma in whom chemotherapy was conducted in the phase of CRF.
  
  
  METHODS
  52 children with nephroblastoma were treated in the Department of Paediatrics, Haematology, Oncology and Endocrinology, Medical University of Gdansk, between 1992 and 2004. Chronic renal failure occurred in two of them. In one patient (case 1) CRF was associated with a congenital complex urinary tract defect (cystic dysplasia of the left kidney, megaureter and bilateral hydronephrosis), in the second one (case 2), CRF resulted from bilateral nephrectomy in the course of relapsing bilateral nephroblastoma.
  
  
  CONCLUSIONS
  Chemotherapy in children with CRF is a serious therapeutical dilemma. The effective dose of the cytotoxic drug, the time of its administration and the periods between the chemotherapy cycles are very difficult to assess for this group of patients. Problems also occur with the achievement of proper energy intake and good physical development of the child.
authors.affiliation: Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii, Akademia Medyczna, ul. Debinki 7, 80-211 Gdańsk, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Stefanowicz
authors.forename: Ewa
authors.initials: E
authors.lastname: Bień
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Zurowska
authors.forename: Krystyna
authors.initials: K
authors.lastname: Schramm
authors.forename: Iga
authors.initials: I
authors.lastname: Załuska-Leśniewska
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Drozyńska
authors.forename: Agata
authors.initials: A
authors.lastname: Maciejewska
authors.forename: Piotr
authors.initials: P
authors.lastname: Czauderna
authors.forename: Grazyna
authors.initials: G
authors.lastname: Gulida
authors.forename: Anna
authors.initials: A
authors.lastname: Balcerska
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D007680:Kidney Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*