Clinical outcomes of pediatric kidney replacement therapy after childhood cancer—An ESPN/ERA Registry study

Cancer and its treatment may lead to kidney injury and the need for kidney replacement therapy (KRT). We identified 287 pediatric KRT patients with a history of malignancy from the European Society for Paediatric Nephrology/European Renal Association Registry. Of these, 197 had cancer as a primary cause of KRT (group 1) and 90 had a malignancy diagnosis before KRT (group 2). Two matched controls without malignancy were randomly selected for each patient. Data were complemented with a questionnaire. Median time to kidney transplantation (KT) from KRT initiation was 2.4 (IQR: 1.5-4.7), 1.5 (IQR: 0.4-3.3), 3.6 (IQR: 1.3 to Q3 not reached), and 1.1 (IQR: 0.3-3.6) years for group 1, their controls, group 2, and their controls, respectively. Overall 10-year mortality for those on KRT was higher among cancer patients vs controls in group 1: 16% vs 9% (adjusted hazard ratio 2.02, 95% CI: 1.21-3.37) and in group 2: 23% vs 14% (adjusted hazard ratio 2.32, 95% CI: 1.11-4.85). In contrast, 10-year patient survival after the first KT was comparable to controls (93% vs 96%; 100% vs 94%, in groups 1 and 2, respectively). In summary, childhood cancer survivors' KT was delayed, and their overall mortality when on KRT was increased, but once transplanted, their long-term outcome was similar to other KT recipients.

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Publication Details

Journal
American Journal of Transplantation
Published
2024-11-07
DOI
https://doi.org/10.1016/j.ajt.2024.11.002
Citations
3
Primary Topic
Childhood Cancer Survivors' Quality of Life
Type
article
Field-Weighted Citation Impact
3.33

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article

Clinical outcomes of pediatric kidney replacement therapy after childhood cancer—An ESPN/ERA Registry study

Manish D. Sinha, Claudia E. Kuehni, Svitlana Fomina, Jérôme Harambat et al.
3 citations
American Journal of Transplantation
Childhood Cancer Survivors' Quality of Life
3.33
article

Clinical outcomes of pediatric kidney replacement therapy after childhood cancer—An ESPN/ERA Registry study

Manish D. Sinha, Claudia E. Kuehni, Svitlana Fomina, Jérôme Harambat, Thérèsa Kwon, Henna Kaijansinkko, Maria S. Molchanova, Maria Szczepańska, Harika Alpay, Timo Jahnukainen, Britta Höcker, Kitty J. Jager, Holger Hubmann, Marjolein Bonthuis, Conceição Mota, Beata Bieniaś, Ann Christin Gjerstad, Rosa Maria Roperto, Enrico Vidal, Lucy Plumb, Karel Vondrák, Kirsi Jahnukainen, Kristine Hommel, Brigitte Adams, Carol Inward, Sevcan Azime Bakkaloglu, E Bíró, Angel Alonso-Melgar
article en
3 citations

Abstract

Cancer and its treatment may lead to kidney injury and the need for kidney replacement therapy (KRT). We identified 287 pediatric KRT patients with a history of malignancy from the European Society for Paediatric Nephrology/European Renal Association Registry. Of these, 197 had cancer as a primary cause of KRT (group 1) and 90 had a malignancy diagnosis before KRT (group 2). Two matched controls without malignancy were randomly selected for each patient. Data were complemented with a questionnaire. Median time to kidney transplantation (KT) from KRT initiation was 2.4 (IQR: 1.5-4.7), 1.5 (IQR: 0.4-3.3), 3.6 (IQR: 1.3 to Q3 not reached), and 1.1 (IQR: 0.3-3.6) years for group 1, their controls, group 2, and their controls, respectively. Overall 10-year mortality for those on KRT was higher among cancer patients vs controls in group 1: 16% vs 9% (adjusted hazard ratio 2.02, 95% CI: 1.21-3.37) and in group 2: 23% vs 14% (adjusted hazard ratio 2.32, 95% CI: 1.11-4.85). In contrast, 10-year patient survival after the first KT was comparable to controls (93% vs 96%; 100% vs 94%, in groups 1 and 2, respectively). In summary, childhood cancer survivors' KT was delayed, and their overall mortality when on KRT was increased, but once transplanted, their long-term outcome was similar to other KT recipients.

American Journal of TransplantationVol. 25(4)
University of Bern (CH), Medical University of Lublin (PL), Oslo University Hospital (NO), University of Udine (IT), University of Debrecen (HU), University of Helsinki (FI), University of Padua (IT), Université de Bordeaux (FR), Medical University of Silesia (PL), King's College London (GB), Medical University of Graz (AT), Charles University (CZ), Heidelberg University (DE), Helsinki University Hospital (FI), Hospital Universitario La Paz (ES), University Hospitals Bristol NHS Foundation Trust (GB), University Hospital of Bern (CH), University Hospital Heidelberg (DE), Centre Hospitalier Universitaire de Bordeaux (FR), Pirogov Russian National Research Medical University (RU), University of Bristol (GB), Helsinki Children's Hospital (FI), University Hospital in Motol (CZ), Bordeaux Population Health (FR), Amsterdam Neuroscience (NL), Administração Regional de Saúde de Lisboa e Vale do Tejo (PT), Meyer Children's Hospital (IT), University Children’s Hospital Bern (CH), Tampere University Hospital (FI), Hôpital Robert-Debré (FR), Hospital de Santo António (PT), Tampere University (FI), Holbæk Sygehus (DK), National Academy of Medical Sciences of Ukraine (UA), Evelina London Children's Healthcare (GB), Amsterdam University Medical Centers (NL), University of Florence (IT), Marmara University (TR), University of Amsterdam (NL), Gazi University (TR), KU Leuven (BE)
Lastentautien Tutkimussäätiö
Good health and well-being
Openalex Percentile: Top 8%
Childhood Cancer Survivors' Quality of Life
3.33
DOIOpen Access PDFOpenAlex
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