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 Gorin, Mohamad E Allaf, Seth Goldstein, Heather DiCarlo, Bhavik B. Shah, Ming Hsien Wang

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)662-666
Number of pages5
JournalJournal of Pediatric Urology
Volume10
Issue number4
DOIs
StatePublished - Aug 1 2014

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Wilms Tumor
Nephrectomy
Glomerular Filtration Rate
Kidney
Chronic Renal Insufficiency
Chronic Kidney Failure
Survivors
Reference Values
Cohort Studies
Retrospective Studies

Keywords

  • Nephrectomy
  • Nephron-sparing surgery
  • Wilms tumor

ASJC Scopus subject areas

  • Urology
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor. / Kern, Adam J M; Inouye, Brian; Ko, Joan S.; Gorin, Michael; Allaf, Mohamad E; Goldstein, Seth; DiCarlo, Heather; Shah, Bhavik B.; Wang, Ming Hsien.

In: Journal of Pediatric Urology, Vol. 10, No. 4, 01.08.2014, p. 662-666.

Research output: Contribution to journalArticle

Kern, Adam J M ; Inouye, Brian ; Ko, Joan S. ; Gorin, Michael ; Allaf, Mohamad E ; Goldstein, Seth ; DiCarlo, Heather ; Shah, Bhavik B. ; Wang, Ming Hsien. / Impact of nephrectomy on long-term renal function in non-syndromic children treated for unifocal Wilms tumor. In: Journal of Pediatric Urology. 2014 ; Vol. 10, No. 4. pp. 662-666.
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AU - Allaf, Mohamad E

AU - Goldstein, Seth

AU - DiCarlo, Heather

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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.

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