title: Renal Late Effects After the Treatment of Unilateral Nonsyndromic Wilms Tumor.
abstract: Wilms tumor is the most common renal malignancy of childhood. Because of the improvement in prognosis and the increase in survival rates, long-term consequences of the treatment for Wilms tumor are of greater concern. We investigated late renal effects of the treatment on 50 survivors of nonsyndromic unilateral Wilms tumor. After the second year since the cessation of treatment, the glomerular filtration rate (GFR), urinary protein excretion, urinary β2 microglobulin levels, and blood pressure as well as the general health status were assessed. Results were analyzed for correlation with clinical variables, chemotherapy, and radiotherapy as possible risk factors. At a median follow-up time of 8.8 years (mean=10.9; range, 2.3 to 35.4 y), none of the patients developed end-stage renal disease. Compensatory hypertrophy was observed in 68% of the cases. The median maximum bipolar length was significantly higher in patients diagnosed after the age of 36 months. Eleven (22%) and 2 (4%) of the 50 patients were hypertensive at the time of the diagnosis and the study, respectively. Similarly, median GFR values were significantly lower at the time of diagnosis, although at the time of the study, all patients had normal GFR values. With longer follow-up intervals, especially after 10 years, a significant decreasing trend in the GFR was observed (P=0.002).
authors.affiliation: Department of Pediatric Oncology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ayse Sevgi
authors.initials: AS
authors.lastname: Kostel Bal
authors.forename: Bilgehan
authors.initials: B
authors.lastname: Yalcin
authors.forename: Hilal
authors.initials: H
authors.lastname: Susam-Şen
authors.forename: Burça
authors.initials: B
authors.lastname: Aydin
authors.forename: Ali
authors.initials: A
authors.lastname: Varan
authors.forename: Tezer
authors.initials: T
authors.lastname: Kutluk
authors.forename: Canan
authors.initials: C
authors.lastname: Akyüz
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006304:Health Status; D006801:Humans; D006984:Hypertrophy; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology; D007680:Kidney Neoplasms; D008875:Middle Aged; D011507:Proteinuria; D013997:Time Factors; D009396:Wilms Tumor / Q000150:complications*; D055815:Young Adult