Long‐term renal prognosis and risk for hypertension after myeloablative therapies in survivors of childhood high‐risk neuroblastoma: A nationwide study
- 30 May 2020
- journal article
- research article
- Published by Wiley in Pediatric Blood & Cancer
- Vol. 67 (8), e28209
- https://doi.org/10.1002/pbc.28209
Abstract
Background Patients with high-risk neuroblastoma (HR NBL) treated with myeloablative regimens are reported to be at risk for cardiovascular morbidity, and this risk may be increased by impaired renal function. Procedure Long-term renal function was assessed in a national cohort of 18 (age 22.4 ± 4.9 years) HR NBL survivors by plasma creatinine (P-Cr), urea, and cystatin C (P-Cys C) concentrations, urine albumin/creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR). Ambulatory blood pressure was monitored, and common carotid intima-media thickness (CIMT) and left ventricular mass index (LVMI) were evaluated. Results No significant difference in P-Cr, P-Cys C, or eGFR was found between the NBL survivors and the age- and sex-matched 20 controls. P-Cys C–based eGFR (eGFRcysc) was significantly lower than the P-Cr–based eGFRcr (97 ± 17 mL/min/1.73 m2 vs 111 ± 19 mL/min/1.73 m2, P < 0.001) among the NBL survivors. The eGFRcysc was below normal in 28%, and ACR was above normal in 22% of the NBL survivors. Abnormal blood pressure was found in 56% of the survivors, and an additional 17% were normotensive at daytime but had significant nocturnal hypertension. Both ACR and P-Cys C were associated with nighttime diastolic hypertension. Conclusions Long-term survivors of childhood HR NBL showed signs of only mild renal dysfunction associated with diastolic hypertension. Elevated ACR and P-Cys C were the most sensitive indicators of glomerular renal dysfunction and hypertension in this patient cohort.Funding Information
- Lastentautien Tutkimussäätiö
- Sigrid Juséliuksen Säätiö
- Lasten Syöpäsäätiö Väreen
- Syöpäjärjestöt
- Academy of Finland
This publication has 22 references indexed in Scilit:
- Long-Term Nephrotoxicity in Adult Survivors of Childhood CancerClinical Journal of the American Society of Nephrology, 2013
- Estimating Glomerular Filtration Rate from Serum Creatinine and Cystatin CThe New England Journal of Medicine, 2012
- Thiotepa and melphalan based single, tandem, and triple high dose therapy and autologous stem cell transplantation for high risk neuroblastomaPediatric Blood & Cancer, 2012
- Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysisThe Lancet, 2010
- Management of high blood pressure in children and adolescents: recommendations of the European Society of HypertensionJournal of Hypertension, 2009
- Hypertension and prehypertension in long‐term survivors of childhood and adolescent cancerPediatric Blood & Cancer, 2007
- Chronic Health Conditions in Adult Survivors of Childhood CancerThe New England Journal of Medicine, 2006
- Long‐term complications in survivors of advanced stage neuroblastomaPediatric Blood & Cancer, 2005
- Twenty-four-hour ambulatory blood pressure in men and women aged 17 to 80 years: the Allied Irish Bank StudyJournal of Hypertension, 1991
- Serum Concentration of Cystatin C, Factor D and β2‐Microglobulin as a Measure of Glomerular Filtration RateActa Medica Scandinavica, 1985