Clinical outcomes of pediatric kidney replacement therapy after childhood cancer—An ESPN/ERA Registry study
Year: 2024
Type: article
Study design: Observational Study
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.
Authors: Henna Kaijansinkko, Marjolein Bonthuis, Kirsi Jahnukainen, Jerome Harambat, Enrico Vidal, Sevcan A. Bakkaloglu, Carol Inward, Manish D. Sinha, Rosa M. Roperto, Claudia E. Kuehni, Erika Biró, Theresa Kwon, Conceição Mota, Brigitte Adams, Maria Szczepańska, Beata Bieniaś, Britta Höcker, Svitlana Fomina, Ann Christin Gjerstad, Karel Vondrak, Harika Alpay, Lucy A. Plumb, Kristine Hommel, Maria S. Molchanova, Holger Hubmann, Angel Alonso-Melgar, Kitty J. Jager, Timo Jahnukainen
Institutions: University of Helsinki, Helsinki University Hospital, Helsinki Children's Hospital, Tampere University Hospital, Amsterdam Public Health, Amsterdam University Medical Centers, University of Amsterdam, Université de Bordeaux, Centre Hospitalier Universitaire de Bordeaux, Bordeaux Population Health, University of Udine, University of Padua, Azienda Ospedale - Università Padova, Gazi University, University Hospitals Bristol and Weston NHS Foundation Trust, St Thomas' Hospital, King's College London, Evelina London Children's Healthcare, Meyer Children's Hospital, University of Florence, University of Bern, University Hospital of Bern, University Children’s Hospital Bern, University of Debrecen, Assistance Publique – Hôpitaux de Paris, Hôpital Robert-Debré, Hospital de Santo António, Unidade Local de Saúde de Santo António EPE, Universitair Ziekenhuis Leuven, Medical University of Silesia, Medical University of Lublin, Heidelberg University, University Hospital Heidelberg, Institute of Nephrology of the National Academy of Medical Sciences of Ukraine, National Academy of Medical Sciences of Ukraine, Oslo University Hospital, Charles University, University Hospital in Motol, Marmara University, University of Bristol, Holbæk Sygehus, Pirogov Russian National Research Medical University, Medical University of Graz, Hospital Universitario La Paz
Language: English
Subfield: Transplantation
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,300
Funder: Lastentautien Tutkimussäätiö
OpenAlex ID: W4404147635