Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors
Little is known about renal function and blood pressure (BP) in long-term childhood cancer survivors. This cross-sectional study evaluated prevalence of these outcomes and associated risk factors in long-term childhood cancer survivors at their first visit to a specialized outpatient clinic. Estimat...
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| Veröffentlicht in: | Clinical journal of the American Society of Nephrology 2012-09, Vol.7 (9), p.1416-1427 |
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| creator | Knijnenburg, Sebastiaan L Jaspers, Monique W van der Pal, Helena J Schouten-van Meeteren, Antoinette Y Bouts, Antonia H Lieverst, Jan A Bökenkamp, Arend Koning, Caro C E Oldenburger, Foppe Wilde, James C H van Leeuwen, Flora E Caron, Huib N Kremer, Leontien C |
| description | Little is known about renal function and blood pressure (BP) in long-term childhood cancer survivors. This cross-sectional study evaluated prevalence of these outcomes and associated risk factors in long-term childhood cancer survivors at their first visit to a specialized outpatient clinic.
Estimated GFR; percentages of patients with albuminuria, hypomagnesemia, and hypophosphatemia; and BP were assessed in 1442 survivors ≥5 years after diagnosis. Multivariable logistic regression analyses were used to estimate effect of chemotherapy, nephrectomy, and radiation therapy on the different outcomes.
At a median age of 19.3 years (interquartile range, 15.6-24.5 years), 28.1% of all survivors had at least one renal adverse effect or elevated BP. The median time since cancer diagnosis was 12.1 years (interquartile range, 7.8-17.5 years). High BP and albuminuria were most prevalent, at 14.8% and 14.5%, respectively. Sixty-two survivors (4.5%) had an estimated GFR |
| doi_str_mv | 10.2215/CJN.09620911 |
| format | Article |
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Estimated GFR; percentages of patients with albuminuria, hypomagnesemia, and hypophosphatemia; and BP were assessed in 1442 survivors ≥5 years after diagnosis. Multivariable logistic regression analyses were used to estimate effect of chemotherapy, nephrectomy, and radiation therapy on the different outcomes.
At a median age of 19.3 years (interquartile range, 15.6-24.5 years), 28.1% of all survivors had at least one renal adverse effect or elevated BP. The median time since cancer diagnosis was 12.1 years (interquartile range, 7.8-17.5 years). High BP and albuminuria were most prevalent, at 14.8% and 14.5%, respectively. Sixty-two survivors (4.5%) had an estimated GFR <90 ml/min per 1.73 m(2). Survivors who had undergone nephrectomy had the highest risk for diminished renal function (odds ratio, 8.6; 95% confidence interval [CI], 3.4-21.4). Combined radiation therapy and nephrectomy increased the odds of having elevated BP (odds ratio, 4.92; 95% CI, 2.63-9.19), as did male sex, higher body mass index, and longer time since cancer treatment.
Almost 30% of survivors had renal adverse effects or high BP. Therefore, monitoring of renal function in high-risk groups and BP in all survivors may help clinicians detect health problems at an early stage and initiate timely therapy to prevent additional damage.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.09620911</identifier><identifier>PMID: 22822016</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Adolescent ; Adult ; Albuminuria - epidemiology ; Albuminuria - physiopathology ; Ambulatory Care Facilities ; Blood Pressure ; Chi-Square Distribution ; Cross-Sectional Studies ; Drug-Related Side Effects and Adverse Reactions ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension - diagnosis ; Hypertension - epidemiology ; Hypertension - physiopathology ; Kidney - physiopathology ; Kidney Diseases - diagnosis ; Kidney Diseases - epidemiology ; Kidney Diseases - physiopathology ; Logistic Models ; Male ; Multivariate Analysis ; Neoplasms - therapy ; Nephrectomy - adverse effects ; Netherlands - epidemiology ; Odds Ratio ; Original ; Prevalence ; Radiation Injuries - diagnosis ; Radiation Injuries - epidemiology ; Radiation Injuries - physiopathology ; Radiotherapy - adverse effects ; Risk Assessment ; Risk Factors ; Survivors - statistics & numerical data ; Time Factors ; Young Adult</subject><ispartof>Clinical journal of the American Society of Nephrology, 2012-09, Vol.7 (9), p.1416-1427</ispartof><rights>Copyright © 2012 by the American Society of Nephrology 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-eaa19da2f16fbff89242d1985790da97a555de7a9fa628ff200771d5ccff8bb13</citedby><cites>FETCH-LOGICAL-c416t-eaa19da2f16fbff89242d1985790da97a555de7a9fa628ff200771d5ccff8bb13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430951/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430951/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22822016$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knijnenburg, Sebastiaan L</creatorcontrib><creatorcontrib>Jaspers, Monique W</creatorcontrib><creatorcontrib>van der Pal, Helena J</creatorcontrib><creatorcontrib>Schouten-van Meeteren, Antoinette Y</creatorcontrib><creatorcontrib>Bouts, Antonia H</creatorcontrib><creatorcontrib>Lieverst, Jan A</creatorcontrib><creatorcontrib>Bökenkamp, Arend</creatorcontrib><creatorcontrib>Koning, Caro C E</creatorcontrib><creatorcontrib>Oldenburger, Foppe</creatorcontrib><creatorcontrib>Wilde, James C H</creatorcontrib><creatorcontrib>van Leeuwen, Flora E</creatorcontrib><creatorcontrib>Caron, Huib N</creatorcontrib><creatorcontrib>Kremer, Leontien C</creatorcontrib><title>Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Little is known about renal function and blood pressure (BP) in long-term childhood cancer survivors. This cross-sectional study evaluated prevalence of these outcomes and associated risk factors in long-term childhood cancer survivors at their first visit to a specialized outpatient clinic.
Estimated GFR; percentages of patients with albuminuria, hypomagnesemia, and hypophosphatemia; and BP were assessed in 1442 survivors ≥5 years after diagnosis. Multivariable logistic regression analyses were used to estimate effect of chemotherapy, nephrectomy, and radiation therapy on the different outcomes.
At a median age of 19.3 years (interquartile range, 15.6-24.5 years), 28.1% of all survivors had at least one renal adverse effect or elevated BP. The median time since cancer diagnosis was 12.1 years (interquartile range, 7.8-17.5 years). High BP and albuminuria were most prevalent, at 14.8% and 14.5%, respectively. Sixty-two survivors (4.5%) had an estimated GFR <90 ml/min per 1.73 m(2). Survivors who had undergone nephrectomy had the highest risk for diminished renal function (odds ratio, 8.6; 95% confidence interval [CI], 3.4-21.4). Combined radiation therapy and nephrectomy increased the odds of having elevated BP (odds ratio, 4.92; 95% CI, 2.63-9.19), as did male sex, higher body mass index, and longer time since cancer treatment.
Almost 30% of survivors had renal adverse effects or high BP. Therefore, monitoring of renal function in high-risk groups and BP in all survivors may help clinicians detect health problems at an early stage and initiate timely therapy to prevent additional damage.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Albuminuria - epidemiology</subject><subject>Albuminuria - physiopathology</subject><subject>Ambulatory Care Facilities</subject><subject>Blood Pressure</subject><subject>Chi-Square Distribution</subject><subject>Cross-Sectional Studies</subject><subject>Drug-Related Side Effects and Adverse Reactions</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Kidney - physiopathology</subject><subject>Kidney Diseases - diagnosis</subject><subject>Kidney Diseases - epidemiology</subject><subject>Kidney Diseases - physiopathology</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Multivariate Analysis</subject><subject>Neoplasms - therapy</subject><subject>Nephrectomy - adverse effects</subject><subject>Netherlands - epidemiology</subject><subject>Odds Ratio</subject><subject>Original</subject><subject>Prevalence</subject><subject>Radiation Injuries - diagnosis</subject><subject>Radiation Injuries - epidemiology</subject><subject>Radiation Injuries - physiopathology</subject><subject>Radiotherapy - adverse effects</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Survivors - statistics & numerical data</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkM1PAjEQxRujEURvnk1vXlxsu9tdejHRFb9C1Cgk3pph27IlS5e0gOG_dwlC9DSTvN-8mXkInVPSZYzy6_zltUtEyoig9AC1Kec8EoR_He77hLbQSQhTQpIkZvwYtRjrMUZo2kajD-2gwvfrYJauWNjaYXAK9yu9goVW-K6qa4XfvQ5h6TW2Dg9qN4mG2s9wXtpKlRs9B1dojz-XfmVXtQ-n6MhAFfTZb-2g0UN_mD9Fg7fH5_x2EBUJTReRBqBCATM0NWNjeoIlTFHR45kgCkQGzf1KZyAMpKxnDCMky6jiRdHA4zGNO-hm6ztfjmdaFdotPFRy7u0M_FrWYOV_xdlSTuqVjJOYCL4xuNoaFL4OwWuzn6VEbuKVTbxyF2-DX_zdt4d3eTbA5RYo7aT8tl7LMIOqanAmiykEl0khafN8_AMPTIVh</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Knijnenburg, Sebastiaan L</creator><creator>Jaspers, Monique W</creator><creator>van der Pal, Helena J</creator><creator>Schouten-van Meeteren, Antoinette Y</creator><creator>Bouts, Antonia H</creator><creator>Lieverst, Jan A</creator><creator>Bökenkamp, Arend</creator><creator>Koning, Caro C E</creator><creator>Oldenburger, Foppe</creator><creator>Wilde, James C H</creator><creator>van Leeuwen, Flora E</creator><creator>Caron, Huib N</creator><creator>Kremer, Leontien C</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20120901</creationdate><title>Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors</title><author>Knijnenburg, Sebastiaan L ; Jaspers, Monique W ; van der Pal, Helena J ; Schouten-van Meeteren, Antoinette Y ; Bouts, Antonia H ; Lieverst, Jan A ; Bökenkamp, Arend ; Koning, Caro C E ; Oldenburger, Foppe ; Wilde, James C H ; van Leeuwen, Flora E ; Caron, Huib N ; Kremer, Leontien C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-eaa19da2f16fbff89242d1985790da97a555de7a9fa628ff200771d5ccff8bb13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Albuminuria - epidemiology</topic><topic>Albuminuria - physiopathology</topic><topic>Ambulatory Care Facilities</topic><topic>Blood Pressure</topic><topic>Chi-Square Distribution</topic><topic>Cross-Sectional Studies</topic><topic>Drug-Related Side Effects and Adverse Reactions</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Kidney - physiopathology</topic><topic>Kidney Diseases - diagnosis</topic><topic>Kidney Diseases - epidemiology</topic><topic>Kidney Diseases - physiopathology</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Multivariate Analysis</topic><topic>Neoplasms - therapy</topic><topic>Nephrectomy - adverse effects</topic><topic>Netherlands - epidemiology</topic><topic>Odds Ratio</topic><topic>Original</topic><topic>Prevalence</topic><topic>Radiation Injuries - diagnosis</topic><topic>Radiation Injuries - epidemiology</topic><topic>Radiation Injuries - physiopathology</topic><topic>Radiotherapy - adverse effects</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Survivors - statistics & numerical data</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Knijnenburg, Sebastiaan L</creatorcontrib><creatorcontrib>Jaspers, Monique W</creatorcontrib><creatorcontrib>van der Pal, Helena J</creatorcontrib><creatorcontrib>Schouten-van Meeteren, Antoinette Y</creatorcontrib><creatorcontrib>Bouts, Antonia H</creatorcontrib><creatorcontrib>Lieverst, Jan A</creatorcontrib><creatorcontrib>Bökenkamp, Arend</creatorcontrib><creatorcontrib>Koning, Caro C E</creatorcontrib><creatorcontrib>Oldenburger, Foppe</creatorcontrib><creatorcontrib>Wilde, James C H</creatorcontrib><creatorcontrib>van Leeuwen, Flora E</creatorcontrib><creatorcontrib>Caron, Huib N</creatorcontrib><creatorcontrib>Kremer, Leontien C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Knijnenburg, Sebastiaan L</au><au>Jaspers, Monique W</au><au>van der Pal, Helena J</au><au>Schouten-van Meeteren, Antoinette Y</au><au>Bouts, Antonia H</au><au>Lieverst, Jan A</au><au>Bökenkamp, Arend</au><au>Koning, Caro C E</au><au>Oldenburger, Foppe</au><au>Wilde, James C H</au><au>van Leeuwen, Flora E</au><au>Caron, Huib N</au><au>Kremer, Leontien C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2012-09-01</date><risdate>2012</risdate><volume>7</volume><issue>9</issue><spage>1416</spage><epage>1427</epage><pages>1416-1427</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Little is known about renal function and blood pressure (BP) in long-term childhood cancer survivors. This cross-sectional study evaluated prevalence of these outcomes and associated risk factors in long-term childhood cancer survivors at their first visit to a specialized outpatient clinic.
Estimated GFR; percentages of patients with albuminuria, hypomagnesemia, and hypophosphatemia; and BP were assessed in 1442 survivors ≥5 years after diagnosis. Multivariable logistic regression analyses were used to estimate effect of chemotherapy, nephrectomy, and radiation therapy on the different outcomes.
At a median age of 19.3 years (interquartile range, 15.6-24.5 years), 28.1% of all survivors had at least one renal adverse effect or elevated BP. The median time since cancer diagnosis was 12.1 years (interquartile range, 7.8-17.5 years). High BP and albuminuria were most prevalent, at 14.8% and 14.5%, respectively. Sixty-two survivors (4.5%) had an estimated GFR <90 ml/min per 1.73 m(2). Survivors who had undergone nephrectomy had the highest risk for diminished renal function (odds ratio, 8.6; 95% confidence interval [CI], 3.4-21.4). Combined radiation therapy and nephrectomy increased the odds of having elevated BP (odds ratio, 4.92; 95% CI, 2.63-9.19), as did male sex, higher body mass index, and longer time since cancer treatment.
Almost 30% of survivors had renal adverse effects or high BP. Therefore, monitoring of renal function in high-risk groups and BP in all survivors may help clinicians detect health problems at an early stage and initiate timely therapy to prevent additional damage.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>22822016</pmid><doi>10.2215/CJN.09620911</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Albuminuria - epidemiology Albuminuria - physiopathology Ambulatory Care Facilities Blood Pressure Chi-Square Distribution Cross-Sectional Studies Drug-Related Side Effects and Adverse Reactions Female Glomerular Filtration Rate Humans Hypertension - diagnosis Hypertension - epidemiology Hypertension - physiopathology Kidney - physiopathology Kidney Diseases - diagnosis Kidney Diseases - epidemiology Kidney Diseases - physiopathology Logistic Models Male Multivariate Analysis Neoplasms - therapy Nephrectomy - adverse effects Netherlands - epidemiology Odds Ratio Original Prevalence Radiation Injuries - diagnosis Radiation Injuries - epidemiology Radiation Injuries - physiopathology Radiotherapy - adverse effects Risk Assessment Risk Factors Survivors - statistics & numerical data Time Factors Young Adult |
| title | Renal Dysfunction and Elevated Blood Pressure in Long-Term Childhood Cancer Survivors |
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