Glomerular filtration rate and prevalence of chronic kidney disease in Wilms' tumour survivors

Pediatr Nephrol. 2011 May;26(5):759-66. doi: 10.1007/s00467-011-1759-3. Epub 2011 Jan 29.

Abstract

Glomerular filtration rate (GFR) was evaluated in 32 Wilms' tumour survivors (WTs) in a cross-sectional study using 99 Tc-diethylene triamine pentaacetic acid (99 Tc-DTPA) clearance, the Schwartz formula, the new Schwartz equation for chronic kidney disease (CKD), cystatin C serum concentration and the Filler formula. Kidney damage was established by beta-2-microglobulin (B-2-M) and albumin urine excretion, urine sediment and ultrasound examination. Blood pressure was measured. No differences were found between the mean GFR in 99 Tc-DTPA and the new Schwartz equation for CKD (91.8 ± 11.3 vs. 94.3 ± 10.2 ml/min/1.73 m(2) [p = 0.55] respectively). No differences were observed between estimated glomerular filtration rate (eGFR) using the Schwartz formula and the Filler formula either (122.3 ± 19.9 vs. 129.8 ± 23.9 ml/min/1.73 m(2) [p = 0.28] respectively). Increased urine albumin and B-2-M excretion, which are signs of kidney damage, were found in 7 (22%) and 3 (9.4%) WTs respectively. Ultrasound signs of kidney damage were found in 14 patients (43%). Five patients (15.6%) had more than one sign of kidney damage. Eighteen individuals (56.25%) had CKD stage I (10 with signs of kidney damage; 8 without). Fourteen individuals (43.75%) had CKD stage II (6 with signs of kidney damage; 8 without). The new Schwartz equation for CKD better estimated GFR in comparison to the Schwartz formula and the Filler formula. Furthermore, the WT survivors had signs of kidney damage despite the fact that GFR was not decreased below 90 ml/min/1.73 m(2) with 99 Tc- DTPA.

MeSH terms

  • Adolescent
  • Antineoplastic Agents / adverse effects
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Glomerular Filtration Rate*
  • Humans
  • Kidney Neoplasms / complications*
  • Kidney Neoplasms / therapy
  • Male
  • Prevalence
  • Radiotherapy / adverse effects
  • Renal Insufficiency, Chronic / diagnostic imaging
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / etiology*
  • Renal Insufficiency, Chronic / physiopathology
  • Survivors / statistics & numerical data
  • Ultrasonography
  • Wilms Tumor / complications*
  • Wilms Tumor / therapy
  • Young Adult

Substances

  • Antineoplastic Agents