In a new study, adult survivors of childhood cancers who had certain chemotherapy treatments or kidney surgery had worse kidney function that did not recover over time. Researchers say this means they may be at higher risk for premature chronic renal failure.
Researchers from the Netherlands say current knowledge suggests that childhood cancer survivors have an increased risk for impaired kidney function following specific cancer therapies, but it has been unknown as to whether their kidney function recovers or worsens over time.
For their study, published in the journal Cancer Epidemiology, Biomarkers and Prevention, the researchers analyzed 1,122 adult childhood cancer survivors aged 18 or over, who visited the Late Effects of Childhood Cancer outpatient clinic at Emma Children's Hospital/Academic Medical Center (EKZ/AMC) between 1966 and 2003.
All participants were monitored from 5 to 42 years following a diagnosis and treatment for cancer.
The researchers investigated the effects of a variety of chemotherapy drugs thought to cause kidney damage over time. These included:
- High-dose methotrexate
- High-dose cyclophosphamide.
They also looked at the effects of kidney-damaging treatments, including radiation therapy to the kidney region and nephrectomy - partial or complete surgical removal of the kidney.
All patients underwent glomerular function testing, and their glomerular filtration rate (GFR) was assessed in order to determine the functionality of their kidneys.
Results of the study showed that childhood cancer survivors who had been treated with ifosfamide or cisplatin, and those who underwent nephrectomy, had lower GFR and higher glomerular dysfunction. This continued throughout the follow-up period.
Additionally, childhood cancer survivors who were treated with high doses of cisplastin showed the highest rate of deterioration in their kidney function.
The study authors note that these results suggest that glomerular function deteriorated in the early years following cancer treatment and failed to recover.
Since glomerular function has shown continued deterioration, they say childhood cancer survivors may be at higher risk of premature chronic kidney disease.
Renée Mulder, research associate of the Department of Pediatric Oncology at EKZ/AMC, says:
"We found that the kidney function of childhood cancer survivors treated with nephrotoxic therapy [treatments known to damage the kidneys] declines very soon after treatment and does not recover.
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."
Medical News Today recently reported on the creation of an artificial kidney that could help those with chronic renal failure.