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Acute kidney injury common in kids with cancer

11 May 2019

Acute kidney injury (AKI) commonly occurs within a year after cancer diagnosis in paediatric patients and is tied to long-term deteriorations in renal function, a recent study has found.

Researchers retrospectively reviewed the medical records of 1,868 children (1,059 males) who were diagnosed with cancer at a median age of 7.9 years. The Kidney Disease: Improving Global Outcomes criteria was used to assess AKI; impaired renal function was defined as proteinuria and an estimated glomerular filtration rate <90 mL/min/1.73 m2.

More than half (52.6 percent; n=983) of the patients developed a total of 1,864 AKI episodes in the first year after cancer diagnosis. The cumulative incidence rates at 2 weeks, 3 months and 1 year after diagnosis were 28.19 percent, 39.6 percent and 53.6 percent respectively. Children with acute myeloid leukaemia (AML; 88.4 percent) and acute lymphoblastic leukaemia (ALL; 77.2 percent) had the highest 1-year cumulative AKI incidence rates.

Almost half (46.1 percent; n=860) of all AKI episodes were stage 1, while 38.3 percent (n=714) were stage 2 and 15.6 percent (n=290) were stage 3. The 1-year cumulative incidence rate of stage 3 AKI was 12.3 percent, and this was highest in those with ALL (27.9 percent) and lowest in patients with Wilms tumour (2.1 percent).

Analysis of long-term renal outcomes was performed in 1,096 participants. After a median follow-up of 5.17 years, the median eGFR was 107.63 mL/min/1.73 m2. A total of 248 participants (22.6 percent) had eGFR <90 mL/min/1.73 m2 and were thus determined to have impaired renal function. Multivariable analysis revealed that having more than four AKI episodes was a significant risk factor for renal impairment.

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Most Read Articles
4 days ago
The consumption of red and processed meats does not seem to affect the likelihood of symptom relapse among Crohn’s disease (CD) patients in relapse, reports a recent study.
Roshini Claire Anthony, 6 days ago

Women who receive a single dose of amoxicillin and clavulanic acid within 6 hours of operative vaginal delivery could significantly reduce their postpartum infection risk, according to the UK-based ANODE* trial.

Pearl Toh, Yesterday
In addition to the known evils of maternal smoking during pregnancy on the son’s semen quality, prenatal exposure to paternal smoking can also be harmful, according to data from a large Danish National Birth Cohort (DNBC) presented at the ESHRE 2019 Meeting.
4 days ago
Treatment with metformin may improve whole-body and peripheral insulin resistance (IR) in youth who are overweight/obese with type 1 diabetes (T1D), according to a study.