[Problems of nephroblastoma therapy in children with chronic renal failure--report of two cases].
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.
Stefanowicz
Joanna
J
Klinika Pediatrii, Hematologii, Onkologii i Endokrynologii, Akademia Medyczna, ul. Debinki 7, 80-211 Gdańsk, Poland.
Bień
Ewa
E
Zurowska
Aleksandra
A
Schramm
Krystyna
K
Załuska-Leśniewska
Iga
I
Drozyńska
Elzbieta
E
Maciejewska
Agata
A
Czauderna
Piotr
P
Gulida
Grazyna
G
Balcerska
Anna
A
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*