Renal involvement in children with malignancies |
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Authors: | R Rossi Robert Kleta Jochen H H Ehrich |
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Institution: | Kinderklinik, St?dtisches Krankenhaus Neuk?lln, Mariendorfer Weg 28, D-12051 Berlin, Germany e-mail: rossir@zedat.fu-berlin.de, Tel.: +49-30-6294-2269, Fax: +49-30-6294-2364, DE Kinderklinik, Westf?lische Wilhelms-Universit?t, Münster, Germany, DE Kinderklinik, Medizinische Hochschule, Hannover, Germany, DE
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Abstract: | Renal complications in children with malignancies primarily arise from renal parenchymal tumors, ”tumor lysis syndrome,”
and malignant infiltration or obstruction of the urinary tract. Therapy-associated renal side effects may develop following
surgical and cytostatic treatment or be induced by radiotherapy. Clinically, both acute renal failure, for example following
cisplatin, or chronic dysfunction, following ifosfamide and resulting in growth failure, are observed. Frequencies of renal
impairment in these patients are, however, not well established, but terminal renal failure is a rare event: pediatric malignancies
account for only 0.9% of patients on renal replacement therapy; the majority of these patients had been treated for a bilateral
nephroblastoma. Since potentially serious long-term renal sequelae may evolve following both single measures and additive
nephrotoxic effects, long-term monitoring of growth, blood pressure, and renal function is mandatory for a great proportion
of former pediatric oncology patients. Future research should prospectively address frequencies of long-term renal impairment
in these patients and should establish the prognosis of renal dysfunction. Only these data will ultimately allow risk-adopted
use of potentially nephrotoxic treatment modalities and adequate counselling of patients.
Received: 20 February 1998 / Revised: 20 May 1998 / Accepted: 20 May 1998 |
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Keywords: | Nephrotoxicity Fanconi syndrome Side effect Long-term sequelae Syndrome of inappropriate antidiuretic hormone Cytostatics Pediatric oncology |
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