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Study: Adult Survivors of Childhood Cancer May Face Renal Problems

Nephrotoxic cancer drugs could lead to chronic renal failure (September 24)

Adult survivors of childhood cancer who underwent certain chemotherapy treatments or kidney surgery had worse kidney function that did not recover over time. Because of this, they may be at higher risk for premature renal failure, according to a new study from Amsterdam, The Netherlands. The study was published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR).

“We found that the kidney function of [childhood cancer survivors] treated with nephrotoxic therapy declines very soon after treatment and does not recover,” said lead researcher Renée Mulder, PhD. “Health care providers and survivors should be aware of the increased risk of early kidney damage after nephrotoxic treatment for childhood cancer, because these patients are also at increased risk for developing comorbidities, such as cardiovascular disease.”

Mulder and colleagues identified 1,122 adult survivors of childhood cancer in Amsterdam. Study participants were 18 years of age or older, and were followed for 5 to 42 years after the diagnosis and treatment of cancer.

The researchers investigated the effect of kidney-damaging treatments on kidney function over time, including the chemotherapy drugs ifosfamide, cisplatin, carboplatin, high-dose methotrexate, and high-dose cyclophosphamide; radiation therapy to the kidney region; and nephrectomy.

The researchers found that, compared with childhood cancer survivors who did not receive kidney-damaging treatments, those who were treated with ifosfamide or cisplatin and those who underwent nephrectomy had a lower glomerular filtration rate (GFR) and greater glomerular dysfunction, and this condition persisted throughout the follow-up period. Furthermore, childhood cancer survivors treated with high doses of cisplatin were found to have the highest rate of kidney-function deterioration.

According to the authors, these results suggest that glomerular function declined in the early years after cancer treatment and did not recover. Moreover, as glomerular function continued to deteriorate, the cancer survivors were at an increased risk for premature chronic renal failure.

Source: AACR; September 24, 2013.

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