Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor

Adam J.M. Kern; Brian Inouye; Joan S. Ko; Michael A. Gorin; Mohamad E. Allaf; Seth Goldstein; Heather N. Dicarlo; Bhavik B. Shah; Ming Hsien Wang

doi:10.1016/j.jpurol.2014.06.017

Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor

Adam J.M. Kern, Brian Inouye, Joan S. Ko, Michael A. Gorin, Mohamad E. Allaf, Seth Goldstein, Heather N. Dicarlo, Bhavik B. Shah, Ming Hsien Wang

Research output: Contribution to journal › Article › peer-review

9 Scopus citations

Abstract

Objective The present study is designed to assess the long-term renal function of children who underwent radical nephrectomy for unifocal Wilms tumor.

Methods A single institution retrospective cohort study of non-syndromic children treated with radical nephrectomy for unifocal Wilms tumor between 1995 and 2011 was performed to identify risk factors for decreased glomerular filtration rate (GFR). The primary endpoint was decrease in age-adjusted GFR below normal published ranges. The secondary endpoint was progression to chronic renal insufficiency (CRI).

Results A total of 55 patients were identified in the cohort. Eight (15%) patients exhibited decreased age-adjusted GFR during the follow-up period, with 2 (4%) progressing to CRI. Increasing time between surgery and the last known GFR follow-up was associated with decreased GFR, with the normal GFR group having median follow-up of 7.32 years versus 11.47 years (p = 0.019) in the decreased GFR group.

Conclusions A trend toward decline in GFR was detected with longer follow-up. Longer follow-up may reveal that clinically significant decline in renal function occurs years following nephrectomy among a subset of Wilms tumor survivors, even among those who do not progress to end stage renal disease.

Original language	English (US)
Pages (from-to)	662-666
Number of pages	5
Journal	Journal of pediatric urology
Volume	10
Issue number	4
DOIs	https://doi.org/10.1016/j.jpurol.2014.06.017
State	Published - Aug 1 2014

Keywords

Nephrectomy
Nephron-sparing surgery
Wilms tumor

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Urology

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10.1016/j.jpurol.2014.06.017

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title = "Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor",

abstract = "Objective The present study is designed to assess the long-term renal function of children who underwent radical nephrectomy for unifocal Wilms tumor.Methods A single institution retrospective cohort study of non-syndromic children treated with radical nephrectomy for unifocal Wilms tumor between 1995 and 2011 was performed to identify risk factors for decreased glomerular filtration rate (GFR). The primary endpoint was decrease in age-adjusted GFR below normal published ranges. The secondary endpoint was progression to chronic renal insufficiency (CRI).Results A total of 55 patients were identified in the cohort. Eight (15%) patients exhibited decreased age-adjusted GFR during the follow-up period, with 2 (4%) progressing to CRI. Increasing time between surgery and the last known GFR follow-up was associated with decreased GFR, with the normal GFR group having median follow-up of 7.32 years versus 11.47 years (p = 0.019) in the decreased GFR group.Conclusions A trend toward decline in GFR was detected with longer follow-up. Longer follow-up may reveal that clinically significant decline in renal function occurs years following nephrectomy among a subset of Wilms tumor survivors, even among those who do not progress to end stage renal disease.",

keywords = "Nephrectomy, Nephron-sparing surgery, Wilms tumor",

author = "Kern, {Adam J.M.} and Brian Inouye and Ko, {Joan S.} and Gorin, {Michael A.} and Allaf, {Mohamad E.} and Seth Goldstein and Dicarlo, {Heather N.} and Shah, {Bhavik B.} and Wang, {Ming Hsien}",

note = "Publisher Copyright: {\textcopyright} 2014 Published by Elsevier Ltd on behalf of Journal of Pediatric Urology Company.",

year = "2014",

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doi = "10.1016/j.jpurol.2014.06.017",

language = "English (US)",

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pages = "662--666",

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T1 - Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor

AU - Kern, Adam J.M.

AU - Inouye, Brian

AU - Ko, Joan S.

AU - Gorin, Michael A.

AU - Allaf, Mohamad E.

AU - Goldstein, Seth

AU - Dicarlo, Heather N.

AU - Shah, Bhavik B.

AU - Wang, Ming Hsien

PY - 2014/8/1

Y1 - 2014/8/1

N2 - Objective The present study is designed to assess the long-term renal function of children who underwent radical nephrectomy for unifocal Wilms tumor.Methods A single institution retrospective cohort study of non-syndromic children treated with radical nephrectomy for unifocal Wilms tumor between 1995 and 2011 was performed to identify risk factors for decreased glomerular filtration rate (GFR). The primary endpoint was decrease in age-adjusted GFR below normal published ranges. The secondary endpoint was progression to chronic renal insufficiency (CRI).Results A total of 55 patients were identified in the cohort. Eight (15%) patients exhibited decreased age-adjusted GFR during the follow-up period, with 2 (4%) progressing to CRI. Increasing time between surgery and the last known GFR follow-up was associated with decreased GFR, with the normal GFR group having median follow-up of 7.32 years versus 11.47 years (p = 0.019) in the decreased GFR group.Conclusions A trend toward decline in GFR was detected with longer follow-up. Longer follow-up may reveal that clinically significant decline in renal function occurs years following nephrectomy among a subset of Wilms tumor survivors, even among those who do not progress to end stage renal disease.

AB - Objective The present study is designed to assess the long-term renal function of children who underwent radical nephrectomy for unifocal Wilms tumor.Methods A single institution retrospective cohort study of non-syndromic children treated with radical nephrectomy for unifocal Wilms tumor between 1995 and 2011 was performed to identify risk factors for decreased glomerular filtration rate (GFR). The primary endpoint was decrease in age-adjusted GFR below normal published ranges. The secondary endpoint was progression to chronic renal insufficiency (CRI).Results A total of 55 patients were identified in the cohort. Eight (15%) patients exhibited decreased age-adjusted GFR during the follow-up period, with 2 (4%) progressing to CRI. Increasing time between surgery and the last known GFR follow-up was associated with decreased GFR, with the normal GFR group having median follow-up of 7.32 years versus 11.47 years (p = 0.019) in the decreased GFR group.Conclusions A trend toward decline in GFR was detected with longer follow-up. Longer follow-up may reveal that clinically significant decline in renal function occurs years following nephrectomy among a subset of Wilms tumor survivors, even among those who do not progress to end stage renal disease.

KW - Nephrectomy

KW - Nephron-sparing surgery

KW - Wilms tumor

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Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor

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