The effect of Wilms tumor chemotherapy on contralateral renal growth after nephrectomy

Abstract

Purpose: Our aim was to evaluate the effect of current Wilms tumor chemotherapy on renal growth and function after unilateral nephrectomy.

Materials and methods: Yorkshire piglets were enrolled in 2 study groups: group 1--6 underwent unilateral nephrectomy and placebo infusion, and group 2--10 underwent nephrectomy, and infusion of 7.5 mcg/kg. actinomycin D and 0.75 mcg/m2 vincristine according to the National Wilms Tumor Study 4 protocol. Weekly measurements of renal size by ultrasound and gross specimens at sacrifice at age 11 weeks were examined and weekly laboratory studies were recorded. Growth rates of renal length and volume were evaluated by linear regression analysis. Terminal renal length and volume were compared between groups.

Results: Mean slope plus or minus standard deviation of the rate of growth in length in the control and chemotherapy groups was 0.067 +/- 0.004 and 0.074 +/- 0.011, respectively (p < or = 0.148, not statistically significant). Mean slope of growth in volume was 1.401 +/- 0.240 versus 1.642 +/- 0.456 (p < or = 0.252), average terminal renal length was 10.71 +/- 1.02 versus 11.58 +/- 1.03 cm (p < or = 0.13, not significant) and mean final volume was 128.67 +/- 32.41 versus 137 +/- 32.52 cc (p < or = 0.65). No differences in final serum creatinine levels were noted.

Conclusions: Chemotherapy for Wilms tumor did not adversely affect contralateral renal growth or function in a nephrectomized piglet model.