title: Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor.
abstract: OBJECTIVE
  The present study is designed to assess the long-term renal function of children who underwent radical nephrectomy for unifocal Wilms tumor.
  
  
  METHODS
  A single institution retrospective cohort study of non-syndromic children treated with radical nephrectomy for unifocal Wilms tumor between 1995 and 2011 was performed to identify risk factors for decreased glomerular filtration rate (GFR). The primary endpoint was decrease in age-adjusted GFR below normal published ranges. The secondary endpoint was progression to chronic renal insufficiency (CRI).
  
  
  RESULTS
  A total of 55 patients were identified in the cohort. Eight (15%) patients exhibited decreased age-adjusted GFR during the follow-up period, with 2 (4%) progressing to CRI. Increasing time between surgery and the last known GFR follow-up was associated with decreased GFR, with the normal GFR group having median follow-up of 7.32 years versus 11.47 years (p = 0.019) in the decreased GFR group.
  
  
  CONCLUSIONS
  A trend toward decline in GFR was detected with longer follow-up. Longer follow-up may reveal that clinically significant decline in renal function occurs years following nephrectomy among a subset of Wilms tumor survivors, even among those who do not progress to end stage renal disease.
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA. Electronic address: adamjmkern@gmail.com.
authors.forename: Adam J M
authors.initials: AJ
authors.lastname: Kern
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Inouye
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Joan S
authors.initials: JS
authors.lastname: Ko
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gorin
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Mohamad E
authors.initials: ME
authors.lastname: Allaf
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Seth
authors.initials: S
authors.lastname: Goldstein
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Heather N
authors.initials: HN
authors.lastname: DiCarlo
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Bhavik B
authors.initials: BB
authors.lastname: Shah
authors.affiliation: James Buchanan Brady Urological Institute, The Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Ming-Hsien
authors.initials: MH
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D009392:Nephrectomy; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D009396:Wilms Tumor / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
keywords: Nephrectomy; Nephron-sparing surgery; Wilms tumor