The Dutch Childhood Cancer Survivor Study (DCCSS)-LATER 2 kidney analysis examined long-term glomerular dysfunction in childhood cancer survivors

被引:8
|
作者
Kooijmans, Esmee C. M. [1 ,2 ,13 ]
van der Pal, Helena J. H. [2 ]
Pluijm, Saskia M. F. [2 ]
van der Heiden-van der Loo, Margriet [2 ,3 ]
Kremer, Leontien C. M. [2 ,4 ,5 ]
Bresters, Dorine [2 ,6 ]
van Dulmen den Broeder, Eline [1 ]
van den Heuvel-Eibrink, Marry M. [2 ,7 ]
Loonen, Jacqueline J. [8 ]
Louwerens, Marloes [9 ]
Neggers, Sebastian J. C. [10 ]
Ronckers, Cecile [2 ]
Tissing, Wim J. E. [2 ,11 ]
de Vries, Andrica C. H. [2 ,7 ]
Kaspers, Gertjan J. L. [1 ,2 ]
Veening, Margreet A. [1 ,2 ]
Bokenkamp, Arend [12 ]
机构
[1] Vrije Univ Amsterdam, Emma Childrens Hosp, Amsterdam UMC, Dept Pediat Oncol, Amsterdam, Netherlands
[2] Princess Maxima Ctr Pediat Oncol, Utrecht, Netherlands
[3] Dutch Childhood Oncol Grp, Utrecht, Netherlands
[4] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Div Child Hlth, Utrecht, Netherlands
[5] Univ Amsterdam, Emma Childrens Hosp, Dept Pediat Oncol, Amsterdam UMC, Amsterdam, Netherlands
[6] Leiden Univ, Med Ctr, Willem Alexander Childrens Hosp, Dept Pediat Oncol, Leiden, Netherlands
[7] Sophia Childrens Univ Hosp, Erasmus Med Ctr, Dept Pediat Oncol, Rotterdam, Netherlands
[8] Radboud Univ Nijmegen, Med Ctr, Dept Hematol, Nijmegen, Netherlands
[9] Leiden Univ, Med Ctr, Dept Internal Med, Leiden, Netherlands
[10] Erasmus MC, Dept Internal Med, Rotterdam, Netherlands
[11] Univ Groningen, Univ Med Ctr Groningen, Dept Pediat Oncol, Groningen, Netherlands
[12] Vrije Univ Amsterdam, Emma Childrens Hosp, Amsterdam UMC, Dept Pediat Nephrol, Amsterdam, Netherlands
[13] Vrije Univ Amsterdam Med Ctr, Amsterdam UMC, PK-1X5 2, Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands
关键词
childhood cancer survivor; glomerular toxicity; late effects; nephrotoxicity; ACUTE LYMPHOBLASTIC-LEUKEMIA; FILTRATION-RATE; RENAL-FUNCTION; CISPLATIN NEPHROTOXICITY; UNILATERAL NEPHRECTOMY; WILMS-TUMOR; CYSTATIN C; ALL-CAUSE; ALBUMINURIA; CHILDREN;
D O I
10.1016/j.kint.2022.05.029
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
This investigation aimed to evaluate glomerular dysfunction among childhood cancer survivors in comparison with matched controls from the general population. In the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER 2 kidney analysis, a nationwide cross-sectional cohort study, 1024 survivors five or more years after diagnosis, aged 18 or more years at study, treated between 1963-2001 with nephrectomy, abdominal radiotherapy, total body irradiation, cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide or hematopoietic stem cell transplantation participated. In addition, 500 age and sex-matched controls from Lifelines, a prospective population-based cohort study in the Netherlands, participated. At a median age of 32.0 years (interquartile range 26.6-37.4), the glomerular filtration rate was under 60 ml/min/1.73m(2) in 3.7% of survivors and in none of the controls. Ten survivors had kidney failure. Chronic kidney disease according to age-thresholds (glomerular filtration rate respectively under 75 for age under 40, under 60 for ages 40-65, and under 40 for age over 65) was 6.6% in survivors vs. 0.2% in controls. Albuminuria (albumin-to-creatinine ratio over3 mg/mmol) was found in 16.2% of survivors and 1.2% of controls. Risk factors for chronic kidney disease, based on multivariable analyses, were nephrectomy (odds ratio 3.7 (95% Confidence interval 2.1-6.4)), abdominal radiotherapy (1.8 (1.1-2.9)), ifosfamide (2.9 (1.9-4.4)) and cisplatin over 500 mg/m(2) (7.2 (3.4-15.2)). For albuminuria, risk factors were total body irradiation (2.3 (1.2-4.4)), abdominal radiotherapy over 30 Gy (2.6 (1.4-5.0)) and ifosfamide (1.6 (1.0-2.4)). Hypertension and follow-up 30 or more years increased the risk for glomerular dysfunction. Thus, lifetime monitoring of glomerular function in survivors exposed to these identified high risk factors is warranted.
引用
收藏
页码:1136 / 1146
页数:11
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