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Patients with a solitary functioning kidney and long-term follow-up of blood pressure and glomerular filtration rate: a comparison between Wilms tumor survivors and nephrectomy for other reasons


Children with unilateral Wilms tumor ( WT ) treated with chemotherapy and/or radiotherapy and nephrectomy have excellent survival rates.
A solitary functioning kidney is associated with progressive renal injury.

A study has investigated the additional effect of Wilms tumor treatment on renal function compared with children with a solitary functioning kidney for non-oncological reasons.

A single-center retrospective cohort study on the renal injury markers of 79 survivors of unilateral Wilms tumor was performed and compared with a matched group of children with an solitary functioning kidney for non-oncological reasons.
Mean age at follow-up was 12.4 ( SD 5.9 ) years.

During follow-up, mean estimated glomerular filtration rate ( eGFR ) and blood pressure z-scores remained stable at an acceptable level.

However, in the group of 31 Wilms tumor patients with a follow-up of 15 years, 23% showed signs of renal injury. This proportion was smaller than the 54% in a group of patients with solitary functioning kidney based on non-oncological causes ( p = 0.004 ).

In conclusion, a significant proportion of Wilms tumor survivors develop renal injury during follow-up.
These data may be an underestimation of the true frequency of progressive renal injury, due to a lack of information on proteinuria.
As with patients with a non-oncological solitary functioning kidney, long-term follow-up is essential to monitor Wilms tumor survivors. ( Xagena )

Mavinkurve-Groothuis AM et al, Pediatr Nephrol 2015; Epub ahead of print

XagenaMedicine_2015



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