title: Long-term renal function in unilateral non-syndromic renal tumor survivors treated according to International Society of Pediatric Oncology protocols.
abstract: BACKGROUND
  The risk of renal impairment among survivors of childhood unilateral non-syndromic renal tumors (RTs) is not well defined. We evaluated the prevalence of and possible risk factors for renal impairment by estimating Glomerular Filtration Rate (eGFR) categories and chronic kidney disease (CKD) according to Kidney Disease: Improving Global Outcomes guidelines.
  
  
  METHODS
  Since 1978, 82 patients were treated for RT, according to the International Society of Pediatric Oncology protocols in a single oncology unit. Of the 67 survivors, those who underwent nephron sparing surgery, those with short-term follow-up or those who had bilateral and/or syndromic disease or a second malignancy were excluded. Thirty-five adult survivors (14 M/21F; mean age 25 years; mean follow-up 20 years) were studied by chemistry, kidney ultrasound, blood pressure measurement, urinanalysis. Correlations were investigated between the prevalence of eGFR categories and CKD and gender, age at diagnosis, radiotherapy, chemotherapy, body mass index, time of follow-up, and age at study.
  
  
  RESULTS
  Eight (22.9%) survivors presented a mildly decreased eGFR (G2 category), the mean value was 80 ± 9.78 ml/min/1.73m(2) (median 84.5, range 63-89). Three (8.6%) survivors had CKD and a fourth (2.9%) hypertension. No significant correlations between G2 category and clinical variables were found.
  
  
  CONCLUSIONS
  A small percentage of survivors had CKD or hypertension after two decades. It is not yet clear whether a mildly decreased eGFR that does not constitute CKD in the absence of other markers (albuminuria and/or kidney ultrasound abnormalities) is likely to progress to CKD. Health promotion programs to avoid comorbidities are required.
authors.affiliation: Department of Pediatrics, "Sapienza" University, Rome, Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: Schiavetti
authors.affiliation: Technical Unit for Radiation, Biology and Human Health, Casaccia ENEA Research Center, Rome, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Altavista
authors.affiliation: Department of Pediatrics, "Sapienza" University, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: De Luca
authors.affiliation: Department of Pediatrics, "Sapienza" University, Rome, Italy.
authors.forename: Gianmarco
authors.initials: G
authors.lastname: Andreoli
authors.affiliation: Department of Pediatrics, "Sapienza" University, Rome, Italy.
authors.forename: Giacomina
authors.initials: G
authors.lastname: Megaro
authors.affiliation: Department of Pediatrics, "Sapienza" University, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Versacci
mesh_terms: D000328:Adult; D000367:Age Factors; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001794:Blood Pressure; D001823:Body Composition; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007668:Kidney / Q000503:physiopathology*; D007680:Kidney Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods; D009399:Nephrons; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods; D011878:Radiotherapy / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017741:Survivors / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
keywords: children; comorbidities; renal function; uninephrectomy