title: Comprehensive renal function evaluation in patients treated for synchronous bilateral Wilms tumor.
abstract: OBJECTIVE
  The purpose of this study was to perform a comprehensive assessment of long-term renal function in patients treated at our institution for synchronous bilateral Wilms tumor (BWT) and to determine the optimal method for estimating glomerular filtration rate (eGFR).
  
  
  METHODS
  Surgical approach, adjuvant therapy, and pathology reports were reviewed for patients with at least six months follow-up from definitive surgery. eGFRs, as assessed by the Schwartz and Chronic Kidney Disease in Children (CKiD) formulas, were compared to measured GFR (mGFR) determined by99mTc-DTPA scanning. Urine studies, including microalbumin, β-microglobulin, and FENawere also reviewed.
  
  
  RESULTS
  Forty-two patients were identified. Of 36 living patients, 28 (77.8%) had greater than 6months follow-up, with a median overall follow-up of 5.2years (range: 1.4-13.4). The median mGFR was 97mL/min/1.73m2, while the median eGFRSchwartzand eGFRCKiDwere 103.3mL/min/1.73m2and 79.7mL/min/1.73m2, respectively, (p=0.13 and p=0.75, compared to mGFR). Eleven (39.3%) patients had at least one abnormal urine study (microalbumin >30μg/g creatinine, n=3; β-2 microglobulin >133μg/g creatinine, n=9; FENa>1%, n=4).
  
  
  CONCLUSIONS
  In our series, few patients had an abnormally low GFR. Neither method for estimating GFR gave a significantly different result from measured GFR, suggesting that the Schwartz equation is adequate, although specific urine tests may be more sensitive for detecting subtle renal dysfunction.
  
  
  METHODS
  Level IV - retrospective case series with no comparison group.
authors.affiliation: Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN; Department of Surgery, University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Rodrigo B
authors.initials: RB
authors.lastname: Interiano
authors.affiliation: Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN.
authors.forename: M Beth
authors.initials: MB
authors.lastname: McCarville
authors.affiliation: Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN.
authors.forename: Noel Delos
authors.initials: ND
authors.lastname: Santos
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN.
authors.forename: Shenghua
authors.initials: S
authors.lastname: Mao
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN.
authors.forename: Jianrong
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Oncology, Children's National Medical Center, Washington, DC.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Dome
authors.affiliation: Department of Urology, Seattle Children's Hospital, Seattle, WA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Kieran
authors.affiliation: Division of Pediatric Urology, Levine Children's Hospital, Charlotte, NC.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Williams
authors.affiliation: Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN; Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN.
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Brennan
authors.affiliation: Department of Radiation Oncology, St. Jude Children's Hospital, Memphis, TN.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Krasin
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Green
authors.affiliation: Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN; Department of Surgery, University of Tennessee Health Science Center, Memphis, TN. Electronic address: andrew.davidoff@stjude.org.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Davidoff
mesh_terms: D059186:Chemoradiotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D007680:Kidney Neoplasms / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D009392:Nephrectomy / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D009396:Wilms Tumor / Q000503:physiopathology* / Q000628:therapy
keywords: Bilateral Wilms tumor; Nephron-sparing surgery; Renal function