GLOMERULAR FILTRATION RATE PROFILES IN PAEDIATRIC PATIENTS ON CANCER CHEMOTHERAPY AT THE KENYATTA NATIONAL HOSPITAL, KENYA

Abstract

Background: An accurate estimation of renal function in children is important in optimising the dose of many drugs used in paediatric oncology for allowing clinical monitoring of the nephrotoxic effects of cytotoxic agents such as cisplatin. The glomerular filtration rate (GFR) is widely accepted as the best index of renal function in patients. Chemotherapy is the mainstay of treatment in the paediatric oncology unit at the Kenyatta National Hospital.

Objectives: To determine the glomerular filtration rate profiles of paediatric oncology patients and to assess changes that had occured over a period of at least six months of continuing cancer chemotherapy.

Design: Cross-sectional hospital based survey.

Setting: General Paediatric wards, including Paediatric Oncology and Paediatric Ophthalmology ward. Kenyatta National Hospital, Nairobi, Kenya. Subjects: Paediatric patients who had an established diagnosis of cancer and had been on chemotherapy for at least six months.

Results: Out of the 115 children enrolledin the study 43 had abnormal kidney function, This gave a prevalence of 37% (95% CI 28-46).The other 72 children had normal kidney function. Patients aged less than five years and those with solid tumors had a higher likelihood of having an abnormal GFR compared to their older counterparts and thosc with-lymphomas and leukemias.

Conclusions: Monitoring of GFR should be done regularly as decline occurs as one continues on chemotherapy especially for the ones below five years and those witl solid malignancies.