Long-term follow-up of renal functions of 108 children who underwent nephrectomy for malignant disease

To evaluate prognosis and to estimate the late effects of irradiation and chemotherapy on renal functions, renal studies were done on 108 children who underwent nephrectomy for malignant disease and were treated postoperatively with irradiation and chemotherapy. The time from nephrectomy to renal studies varied from less than 6 months to 18 years; the median time was 6.5 years. Postnephrectomy follow-up consisted of repeated urine examinations and cultures, clearances of endogenous creatinine, evaluations of Addis count and blood urea nitrogen, intravenous pyelograms, and radioisotopic renal scans with Hg197 tagged to chlormerodrin. The study indicated that normal renal functions could be preserved in pediatric patients after unilateral nephrectomy, irradiation, and administration of antitumor drugs, providing that irradiation of the remaining kidney was kept below 1,200 R. Although the incidence of urinary tract infections was higher than in normal children, no impairment of renal function followed, if adequate and prompt treatment was administered.