Renal size and function after cure of Wilms' tumour

Now that most patients with Wilms' tumour are cured, it is practicable to study the long-term morbidity of their treatment and use this information to reduce treatment sequelae in the future. In this study we evaluate the size and function of the remaining kidney in 53 survivors of Wilms'...

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Bibliographic Details
Published in:British journal of cancer 1992-11, Vol.66 (5), p.877-882
Main Authors: LEVITT, G. A, YEOMANS, E, MIREAUX, C. D, BREATNACH, F, KINGSTON, J, PRITCHARD, J
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Pressure - physiology
Child
Child, Preschool
Female
Follow-Up Studies
Glomerular Filtration Rate - physiology
Humans
Infant
Kidney - anatomy & histology
Kidney - growth & development
Kidney - physiology
Kidney Diseases - etiology
Kidney Diseases - physiopathology
Kidneys
Male
Medical sciences
Nephrology. Urinary tract diseases
Organ Size
Renin - blood
Risk Factors
Tumors of the urinary system
Wilms Tumor - complications
Wilms Tumor - physiopathology
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Summary:Now that most patients with Wilms' tumour are cured, it is practicable to study the long-term morbidity of their treatment and use this information to reduce treatment sequelae in the future. In this study we evaluate the size and function of the remaining kidney in 53 survivors of Wilms' tumour with a mean off treatment follow-up of 13 years. There was evidence of renal dysfunction in 17 (32%), including ten (19%) with a low GFR (< 80 ml/min/1.73 m2SA), six (11%) with hypertension and five (9%) with increased urinary albumin excretion. Measurements of renal size showed 'good' renal compensatory hypertrophy in only 55% of patients. 'Good' refers to renal size of more than 2 s.d. above the mean renal length for children with two kidneys. There were no correlations between GFR, renal size, blood pressure, microalbuminuria or type of treatment. However, children less than 24 months at diagnosis and children receiving chemotherapy with radiation doses to remaining kidney of more than 1200 cGy had a worse renal prognosis. Patients whose Wilms' tumour is diagnosed in infancy should have careful long-term follow-up of renal function and size. Older patients may safely be followed up less often, unless their remaining kidney was received > 1200 cGy.
ISSN:0007-0920
1532-1827
DOI:10.1038/bjc.1992.378