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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
6 days ago
In patients with type 2 diabetes, obesity may be protective against vision-threatening diabetic retinopathy, a recent Korea study has shown.
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The aromatase inhibitor anastrozole shows promise in the treatment of children with congenital adrenal hyperplasia, reducing bone age advancement without adversely affecting bone mineral density and visceral adipose tissue, as shown in a recent study.
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