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Kidney Disease in Childhood Cancer Survivors

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Late Treatment Effects and Cancer Survivor Care in the Young

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Abstract

Chronic glomerular and tubular nephrotoxicity has been reported in up to 50% and 25%, respectively, of children and adolescents treated with ifosfamide and up to 60% and 30% of those given cisplatin. Up to 35% of children have proteinuria and microalbuminuria, implying chronic glomerular damage, after unilateral nephrectomy for a renal tumour. We are still learning about nephrotoxicity due to the new targeted anticancer drugs. Overall, childhood cancer survivors have nine times greater risk of developing renal failure than their siblings. Such chronic nephrotoxicity may have multiple causes including certain chemotherapy agents (especially ifosfamide and platinum agents), radiotherapy to the kidneys, renal surgery, supportive care drugs and tumour-related factors. These cause a wide range of chronic glomerular and tubular toxicity, often with potentially severe clinical sequelae. Although many risk factors for developing nephrotoxicity, mostly patient and treatment-related, have been described, they do not predict all children who subsequently develop chronic renal damage. This suggests that other factors may be involved, such as genetic polymorphisms influencing drug metabolism. Further research is necessary to enable prediction or early detection of nephrotoxicity, whilst greater understanding of the pathogenesis of nephrotoxicity is needed to allow us to prevent its occurrence in the future.

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Author information

Authors and Affiliations

  1. Department of Paediatric and Adolescent Haematology/Oncology, and Children’s Haemopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, and faculty reorganisation, Newcastle University Centre for Cancer, Clinical and Translational Research Institute, Newcastle University, Newcastle upon Tyne, UK

    Roderick Skinner

  2. Department of Clinical Sciences Lund, Pediatrics, Skane University Hospital, Lund University, Lund, Sweden

    Lars Hjorth

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  1. Roderick Skinner
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  2. Lars Hjorth
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Correspondence to Roderick Skinner .

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Editors and Affiliations

  1. Department of Pediatrics, University Children’s Hospital, Erlangen, Germany

    Jörn D. Beck

  2. Department of Onkology, University Hospital Hamburg-Eppendorf, Hamburg, Germany

    Carsten Bokemeyer

  3. Pediatric Oncology and Hematology – Long-Term Follow-Up after Childhood Cancer, University Hospital for Children and Adolescents, Lübeck, Germany

    Thorsten Langer

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Skinner, R., Hjorth, L. (2021). Kidney Disease in Childhood Cancer Survivors. In: Beck, J.D., Bokemeyer, C., Langer, T. (eds) Late Treatment Effects and Cancer Survivor Care in the Young. Springer, Cham. https://doi.org/10.1007/978-3-030-49140-6_2

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  • DOI: https://doi.org/10.1007/978-3-030-49140-6_2

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