(Press-News.org) PHILADELPHIA -- Adult survivors of childhood cancers who underwent certain chemotherapy treatments or kidney surgery had worse kidney function that did not recover over time. Because of this, they may be at higher risk for premature renal failure, according to a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research.
"Current knowledge suggests childhood cancer survivors (CCS) have an increased risk for impaired kidney function after specific cancer therapies; however, it was not known whether their kidney function recovers with time or if it gets worse," said Renée Mulder, Ph.D., research associate in the Department of Pediatric Oncology at Emma Children's Hospital/Academic Medical Center (EKZ/AMC) in Amsterdam, the Netherlands. "This is the first longitudinal cohort study that takes into account multiple measurements of kidney function over time within the same patient to evaluate time trends in a large group of CCS with a long and nearly complete follow-up.
"We found that the kidney function of CCS treated with nephrotoxic therapy [treatments known to damage the kidneys] declines very soon after treatment and does not recover. Health care providers and survivors should be aware of the increased risk of early kidney damage after nephrotoxic treatment for childhood cancer, because these patients are also at increased risk for developing comorbidities, such as cardiovascular disease," she added.
Mulder and colleagues identified 1,122 study participants from adult CCS who visited the Late Effects of Childhood Cancer outpatient clinic at EKZ/AMC between 1996 and 2010. Participants were 18 years of age or older, and were followed for five to 42 years after a diagnosis and treatment for cancer.
To help determine the functionality of their kidneys, all participants underwent glomerular function testing and had an assessment of their glomerular filtration rate (GFR). Participants underwent at least one measurement of GFR, and 920 of them had two to 15 measurements during follow-ups.
The researchers investigated the effect of kidney-damaging treatments on kidney function over time, including chemotherapy drugs ifosfamide, cisplatin, carboplatin, high-dose methotrexate, and high-dose cyclophosphamide; radiation therapy to the kidney region; and nephrectomy (partial or complete surgical removal of the kidney).
The researchers found that compared with CCS who did not receive kidney-damaging treatments, those who were treated with ifosfamide or cisplatin and those who underwent nephrectomy had lower GFR and higher glomerular dysfunction, and this condition persisted throughout the follow-up period. Further, CCS treated with high doses of cisplatin were found to have the highest rate of kidney function deterioration.
According to the study authors, these results suggest that glomerular function declined in the early years after cancer treatment and did not recover, and as it continues to deteriorate, these CCS are at an increased risk for premature chronic renal failure.
###
This study was funded by the Tom Voûte Fund, Amsterdam. The authors have declared no conflicts of interest.
Follow the AACR on Twitter: @AACR
Follow the AACR on Facebook: http://www.facebook.com/aacr.org
About the American Association for Cancer Research
Founded in 1907, the American Association for Cancer Research (AACR) is the world's oldest and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than 34,000 laboratory, translational, and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis, and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 18,000 attendees. In addition, the AACR publishes eight peer-reviewed scientific journals and a magazine for cancer survivors, patients, and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the scientific partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration, and scientific oversight of team science and individual grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer. For more information about the AACR, visit http://www.AACR.org.
Some childhood cancer survivors may face subsequent renal problems
2013-09-25
ELSE PRESS RELEASES FROM THIS DATE:
Diet and exercise for knee osteoarthritis produces greater improvement in knee pain, function
2013-09-25
Among overweight and obese adults with knee osteoarthritis, combining intensive diet and exercise led to less knee pain and better function after 18 months than diet-alone and exercise-alone, according to a study in the September 25 issue of JAMA.
"Osteoarthritis (OA) is the leading cause of chronic disability among older adults. Knee OA is the most frequent cause of mobility dependency and diminished quality of life, and obesity is a major risk factor for knee OA. Current treatments for knee OA are inadequate; of patients treated pharmacologically, only about half experience ...
Study findings question frequency of bone mineral density testing for predicting fracture risk
2013-09-25
A second bone mineral density (BMD) screening four years after a baseline measurement provided little additional value when assessing risk for hip or other major osteoporotic fracture among older men and women untreated for osteoporosis, and resulted in little change in risk classification used in clinical management, findings that question the common clinical practice of repeating a BMD test every 2 years, according to a study in the September 25 issue of JAMA.
Bone mineral density testing is important in the management of osteoporosis. Guidelines for initiating pharmacologic ...
Sensor-augmented insulin pump therapy reduces rate of severe hypoglycemic events
2013-09-25
Use of an insulin pump with a sensor that suspends insulin delivery when blood glucose falls below a set threshold reduced the rate of severe and moderate hypoglycemia among patients with type 1 diabetes and impaired awareness of hypoglycemia, according to a study in the September 25 issue of JAMA.
Hypoglycemia is a critical obstacle to the care of patients with type 1 diabetes. Sensor-augmented pump therapy with an automated insulin suspension or low glucose suspension function is a technology has the potential to reduce the duration and frequency of significant hypoglycemia, ...
Decision-making tool may help rule out brain hemorrhage for patients in emergency department
2013-09-25
Researchers have developed a simple clinical decision rule that may help doctors identify patients with headache in the emergency department who have subarachnoid hemorrhage (bleeding in a certain area of the brain), according to a study in the September 25 issue of JAMA.
"Headache accounts for approximately 2 percent of all emergency department visits, and subarachnoid hemorrhage is one of the most serious diagnoses, accounting for only 1 percent to 3 percent of these headaches. Although the decision to evaluate patients with new neurologic deficits is relatively straightforward, ...
Prevalence of poorer kidney function increases among adults 80 years of age and older
2013-09-25
Recent studies have shown that older adults with chronic kidney disease (CKD; defined as an estimated glomerular filtration rate [GFR; a measure of kidney function] of less than 60 mL/min/1.73 m2) have a high prevalence of concurrent complications and increased risk for adverse outcomes including mortality, cardiovascular disease, and kidney failure. A prior study demonstrated an increase in CKD prevalence between 1988-1994 and 1999-2004 for the general U.S. population. However, trends in CKD prevalence have not been reported for the oldest old [defined as 80 years of age ...
Acupuncture & care may help depression; Pneumococcal infection vaccine; A disruptive medical journal
2013-09-25
Everything published by PLOS Medicine is open access: freely available for anyone to read, download, redistribute and otherwise use, as long as the authorship is properly attributed.
Please mention PLOS Medicine in your report and use the links below to take your readers straight to the online articles:
Acupuncture or counselling plus usual care may improve depression symptoms
Vaccine against pneumococcal infections has led to widespread reduction in serious disease
The importance of a medical journal being disruptive
Improved strategies are needed to assess ...
Vitamin D alone does little to protect bone health in postmenopausal women
2013-09-25
Chevy Chase, MD—While calcium supplements noticeably improved bone health in postmenopausal women, vitamin D supplements did not reduce bone turnover, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Bone turnover is the body's natural process for breaking down old bone. In young people, the body forms enough new bone to replace what is lost. After age 30, however, bone mass in women begins to decline and the process speeds up after menopause. Osteoporosis develops when the body cannot ...
Low testosterone may be linked to heart problems
2013-09-25
Chevy Chase, MD—Men who have low testosterone levels may have a slightly elevated risk of developing or dying from heart disease, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Testosterone is a key male sex hormone that helps maintain sex drive, sperm production and bone health. Over time, low testosterone may contribute to an increase in body fat, loss of body hair and muscle bulk.
"When we reviewed the existing research into testosterone and cardiovascular disease, a growing ...
Study findings may explain delayed onset of heart disease in women
2013-09-25
Chevy Chase, MD—A biological ability to compensate for the body's reduced response to insulin may explain why women typically develop heart disease 10 years later than men, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Insulin is a hormone that takes glucose from the bloodstream and carries it into cells, where it is used for energy. When the body doesn't use insulin properly, a condition known as insulin resistance, it raises the risk a person will develop diabetes and cardiovascular ...
NYU Steinhardt researcher pinpoints biological risk factor in obesity-related cancers
2013-09-25
It is estimated that over a third of the new cancer cases expected to occur in the U.S. in 2013 will be related to overweight or obesity, physical inactivity, and poor nutrition. Thanks to the work of one NYU Steinhardt researcher, we may better understand why.
Nutritional epidemiologist Niyati Parekh's latest research study, which appears in the journal Cancer Epidemiology, Biomarkers, and Prevention, concludes that disturbances in body insulin and glucose levels, specifically exposures to longer periods, are associated with an increased risk of obesity-related cancers ...