title: Treatments and outcomes for end-stage renal disease following Wilms tumor.
abstract: BACKGROUND
  Little is known about treatment outcomes for children who have end-stage renal disease (ESRD) after treatment for Wilms tumor (WT).
  
  
  METHODS
  Time-to-transplant, graft failure, and survival outcomes were examined for 173 children enrolled on the National Wilms Tumor Study who developed ESRD.
  
  
  RESULTS
  Fifty-five patients whose ESRD resulted from progressive bilateral WT (PBWT) experienced high early mortality from WT that limited their opportunity for transplant (47% at 5 years) and survival (44% at 10 years) in comparison to population controls. The 118 patients whose ESRD was due to other causes (termed "chronic kidney disease"), many of whom had WT-associated congenital anomalies, had transplant (77% at 5 years) and survival (73% at 10 years) outcomes no worse than those for population controls. Graft failure following transplant was comparable for the two groups. Minority children had twice the median time to transplant as non-Hispanic whites and twice the mortality rates, also reflecting population trends.
  
  
  CONCLUSIONS
  In view of the continuing high mortality in patients with ESRD, and the dramatic improvement in outlook following kidney transplantation, re-evaluation of current guidelines for a 2-year delay in transplant following WT treatment may be warranted.
authors.affiliation: Department of Biostatistics and Bioinformatics, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Yevgeny
authors.initials: Y
authors.lastname: Grigoriev
authors.forename: Jane
authors.initials: J
authors.lastname: Lange
authors.forename: Susan M
authors.initials: SM
authors.lastname: Peterson
authors.forename: Janice R
authors.initials: JR
authors.lastname: Takashima
authors.forename: Michael L
authors.initials: ML
authors.lastname: Ritchey
authors.forename: Dicken
authors.initials: D
authors.lastname: Ko
authors.forename: James H
authors.initials: JH
authors.lastname: Feusner
authors.forename: Robert C
authors.initials: RC
authors.lastname: Shamberger
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Green
authors.forename: Norman E
authors.initials: NE
authors.lastname: Breslow
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000401:mortality* / Q000601:surgery; D007680:Kidney Neoplasms / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation / Q000401:mortality*; D008297:Male; D016019:Survival Analysis; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000150:complications* / Q000601:surgery