Comprehensive renal function evaluation in patients treated for synchronous bilateral Wilms tumor.
Document Type
Journal Article
Publication Date
1-1-2017
Journal
Journal of Pediatric Surgery
Volume
52
Issue
1
Inclusive Pages
98-103
DOI
10.1016/j.jpedsurg.2016.10.027
Keywords
Chemoradiotherapy, Adjuvant; Child; Child, Preschool; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Infant; Kidney Neoplasms; Male; Nephrectomy; Retrospective Studies; Treatment Outcome; Wilms Tumor
Abstract
OBJECTIVES: The purpose of this study was to perform a comprehensive assessment of long-term renal function in patients treated at our institution for synchronous bilateral Wilms tumor (BWT) and to determine the optimal method for estimating glomerular filtration rate (eGFR).
METHODS: Surgical approach, adjuvant therapy, and pathology reports were reviewed for patients with at least six months follow-up from definitive surgery. eGFRs, as assessed by the Schwartz and Chronic Kidney Disease in Children (CKiD) formulas, were compared to measured GFR (mGFR) determined by (99m)Tc-DTPA scanning. Urine studies, including microalbumin, β-microglobulin, and FENa were also reviewed.
RESULTS: Forty-two patients were identified. Of 36 living patients, 28 (77.8%) had greater than 6months follow-up, with a median overall follow-up of 5.2years (range: 1.4-13.4). The median mGFR was 97mL/min/1.73m(2), while the median eGFRSchwartz and eGFRCKiD were 103.3mL/min/1.73m(2) and 79.7mL/min/1.73m(2), respectively, (p=0.13 and p=0.75, compared to mGFR). Eleven (39.3%) patients had at least one abnormal urine study (microalbumin >30μg/g creatinine, n=3; β-2 microglobulin >133μg/g creatinine, n=9; FENa>1%, n=4).
CONCLUSIONS: In our series, few patients had an abnormally low GFR. Neither method for estimating GFR gave a significantly different result from measured GFR, suggesting that the Schwartz equation is adequate, although specific urine tests may be more sensitive for detecting subtle renal dysfunction.
LEVEL OF EVIDENCE: Level IV - retrospective case series with no comparison group.
APA Citation
Interiano, R., McCarville, M., Santos, N., Mao, S., Wu, J., Dome, J., Kieran, K., Williams, M., Brennan, R., Krasin, M., Green, D., & Davidoff, A. (2017). Comprehensive renal function evaluation in patients treated for synchronous bilateral Wilms tumor.. Journal of Pediatric Surgery, 52 (1). http://dx.doi.org/10.1016/j.jpedsurg.2016.10.027
Peer Reviewed
1
