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Hypertension in Wilms tumor

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Abstract

Wilms tumor (WT) represents over 90% of all pediatric kidney tumors. Children with WT often present acutely with hypertension which resolves in the short term after nephrectomy. However, WT survivors have increased long-term risk of hypertension, primarily due to decreased nephron mass after nephrectomy, with additional insults from possible exposure to abdominal radiation and nephrotoxic therapies. The diagnosis of hypertension may be improved by ambulatory blood pressure monitoring (ABPM), as several recent single-center studies have shown a substantial proportion of WT survivors with masked hypertension. Current gaps in knowledge include determining which WT patients may benefit from routine screening with ABPM, correlation of casual and ABPM parameters with cardiac abnormalities, and longitudinal assessment of cardiovascular and kidney parameters in relation to appropriate treatment of hypertension. This review aims to summarize the most recent literature on hypertension presentation and management at the time of WT diagnosis as well as the long-term hypertension risk and impact on kidney and cardiovascular outcomes in WT survivors.

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  1. Division of Nephrology, Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Wendy Hsiao, Michelle Denburg & Benjamin Laskin

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  1. Wendy Hsiao
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Michelle Denburg serves on the KDIGO Executive Committee and on the editorial board of Kidney International Reports. The authors have no other relevant financial or non-financial interests to declare. No funding was received to assist with the preparation of this manuscript .

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Hsiao, W., Denburg, M. & Laskin, B. Hypertension in Wilms tumor. Pediatr Nephrol 39, 15–24 (2024). https://doi.org/10.1007/s00467-023-06011-y

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