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. 2023 Jan;12(2):1330-1338.
doi: 10.1002/cam4.5010. Epub 2022 Jul 16.

Kidney disease in very long-term survivors of Wilms tumor: A nationwide cohort study with sibling controls

Stine Høgsholt  1   2 , Peter Haubjerg Asdahl  3 , Catherine Rechnitzer  4 , Jeanette Falck Winther  2   5 , Henrik Birn  2   6   7 , Henrik Hasle  1   2
Affiliations

Kidney disease in very long-term survivors of Wilms tumor: A nationwide cohort study with sibling controls

Stine Høgsholt et al. Cancer Med. 2023 Jan.

Abstract

Background: Survival after Wilms tumor has significantly increased and focus on late effects has become increasingly important. However, knowledge about long-term renal function in survivors of Wilms tumor is missing. Our aim was to investigate evidence of kidney disease in 20- or more-year survivors of Wilms tumor in a clinical setting, with siblings as comparisons.

Methods: In this cross-sectional study, we established a cohort of Danish 20-plus-year survivors of Wilms tumor and siblings as controls. Participants answered a comprehensive health questionnaire supplemented by measurements of estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio, and blood pressure and were categorized according to the chronic kidney disease classification. Multiple linear regression analysis, taking family membership into account, was used to describe the differences in eGFR. Logistic regression analysis was performed to describe risk factors for the development of kidney disease.

Results: We included 99 survivors of Wilms tumor and 38 sibling controls with a median of 37 years of follow-up. The eGFR of Wilms tumor survivors was 13 ml/min/1.73 m2 (95% CI -20; -5) lower when compared to sibling control. Evidence of kidney disease, with risk factors as hypertension and diabetes, was found in 19% of the Wilms tumor survivors and 2% developed end-stage renal disease. Ninety-two percent of the Wilms tumor survivors had an eGFR >60 ml/min/1.732 .

Conclusion: Long-term Wilms tumor survivors have on average a significantly decreased renal function along with the increased prevalence of kidney disease and end-stage renal disease when compared to sibling controls. Still, most survivors had kidney function within the normal range.

Keywords: Wilms tumor; chronic kidney disease; late effects; survivorship.

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Conflict of interest statement

None of the authors have conflict of interests to declare.

Figures

FIGURE 1
FIGURE 1
Flowchart with study eligibility, recruitment, and the final size of the Wilms tumor cohort.
FIGURE 2
FIGURE 2
Box plot of eGFR (ml/min/1.73 m2) for 97 Wilms tumor survivors and 38 sibling controls.
FIGURE 3
FIGURE 3
Chronic kidney disease (CKD) classification of the 99 Wilms tumor patients. Nineteen of the 99 (19%) patients are classified with CKD with moderate, high, or very high risk.
See this image and copyright information in PMC

References

    1. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56(2):106‐130. - PubMed
    1. Breslow N, Olshan A, Beckwith JB, Green DM. Epidemiology of Wilms tumor. Med Pediatr Oncol. 1993;21(3):172‐181. - PubMed
    1. Green DM. The treatment of stages I‐IV favorable histology Wilms' tumor. J Clin Oncol. 2004;22(8):1366‐1372. - PubMed
    1. Pritchard‐Jones K, Moroz V, Vujanić G, et al. Treatment and outcome of Wilms' tumour patients: an analysis of all cases registered in the UKW3 trial. Ann Oncol. 2012;23(9):2457‐2463. - PubMed
    1. Spreafico F, Bellani FF. Wilms' tumor: past, present and (possibly) future. Expert Rev Anticancer Ther. 2006;6(2):249‐258. - PubMed

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