title: Risk factors for cisplatin-induced long-term nephrotoxicity in pediatric cancer survivors.
abstract: BACKGROUND
  The aim of this study was to compare the nephrotoxicity risk of cisplatin (CPL) and ifosfamide (IFO) combination treatment (CT) with that of CPL alone and to evaluate the prevalence of CPL-induced long-term nephrotoxicity in pediatric cancer survivors (CS).
  
  
  METHODS
  A total of 33 patients with pediatric solid tumors who have been cured of their disease were included in the study. They were divided into two groups based on the type of chemotherapeutics, either CPL (n = 21) or CT (n = 12), given during cancer treatment and were evaluated for glomerular and tubular function using the Skinner grading system.
  
  
  RESULTS
  Nephrotoxicity was found in 15 CS (45.4%): seven (21.3%) of those had moderate, six (18.2%) had mild, and two (6.1%) had severe nephrotoxicity. Neither the rates of overall nephrotoxicity, glomerular toxicity and tubular toxicity, nor the mean overall, glomerular and tubular toxicity scores differed significantly among the CPL and CT groups (P > 0.05 for all parameters). Cumulative IFO dose and age at treatment were found to be independent risk factors for both development and severity of CPL-induced nephrotoxicity (P = 0.025 and P = 0.036 for development of nephrotoxicity; P = 0.004 and P = 0.050 for severity of nephrotoxicity, respectively).
  
  
  CONCLUSIONS
  Although CPL-induced long-term nephrotoxicity was found in half of the pediatric CS of solid tumors, clinically significant nephrotoxicity was detected only in a minority of them. Both higher cumulative IFO dose and younger age at treatment were found to be independent risk factors for both development and severity of CPL-induced nephrotoxicity.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arga
authors.affiliation: Department of Pediatric Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Oguz
authors.affiliation: Department of Pediatric Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Faruk Guclu
authors.initials: FG
authors.lastname: Pinarli
authors.affiliation: Department of Pediatric Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Ceyda
authors.initials: C
authors.lastname: Karadeniz
authors.affiliation: Department of Pediatric Oncology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Elvan Caglar
authors.initials: EC
authors.lastname: Citak
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Hamdi Cihan
authors.initials: HC
authors.lastname: Emeksiz
authors.affiliation: Department of Statistics, Istanbul Medeniyet University, Istanbul, Turkey.
authors.forename: Esra Akdeniz
authors.initials: EA
authors.lastname: Duran
authors.affiliation: Department of Pediatric Nephrology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Oguz
authors.initials: O
authors.lastname: Soylemezoglu
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality*; D012307:Risk Factors; D017741:Survivors / Q000706:statistics & numerical data*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: children; cisplatin; ifosfamide; late sequelae; nephrotoxicity