TY - JOUR
T1 - The incidence and outcome of acute kidney injury during pediatric kidney tumor treatment-a national cohort study
AU - Raymakers-Janssen, Paulien A M A
AU - van den Berg, Gerrit
AU - Lilien, Marc R
AU - van Kessel, Inge A
AU - van der Steeg, Alida F W
AU - Wijnen, Marc H W A
AU - Triest, Mieke I
AU - van Peer, Sophie E
AU - Jongmans, Marjolijn C J
AU - van Tinteren, Harm
AU - Janssens, Geert O
AU - Fiocco, Marta
AU - Wösten-van Asperen, Roelie M
AU - van den Heuvel-Eibrink, Marry M
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/7
Y1 - 2025/7
N2 - BACKGROUND: Acute kidney injury (AKI) is a serious complication of pediatric cancer treatment that is suggested to increase the risk of chronic kidney disease (CKD). Children with a kidney tumor may be at particular risk. This study aimed to determine the incidence and risk factors of AKI and its association with CKD during pediatric kidney tumor treatment.METHODS: We analyzed data from a prospective national cohort of patients ≤ 18 years old diagnosed with a kidney tumor between 2015 and 2021 in the Princess Máxima Center for Pediatric Oncology in the Netherlands. AKI was defined according to KDIGO criteria. CKD was assessed 1 year post-treatment based on proteinuria and/or decreased estimated glomerular filtration rate (eGFR).RESULTS: Of 147 patients, we observed AKI in 104 patients (71%) during therapy. AKI occurred most often within 48 h after tumor nephrectomy (88/104), while the rest had non-nephrectomy-related AKI from multifactorial causes. Sixteen patients experienced more than one AKI episode, and 92/104 episodes were reversible. Patients who developed AKI had a higher eGFR prior to surgery compared to those who did not develop AKI. CKD was observed in 16/120 patients (13%). Risk factors for developing CKD included the occurrence of at least 1 AKI event, the use of a > 3-drug regimen, and a lower eGFR at the start of treatment.CONCLUSION: The high incidence of AKI and its association with early CKD highlights the need for early detection, prevention, and intervention strategies during pediatric kidney tumor treatment.
AB - BACKGROUND: Acute kidney injury (AKI) is a serious complication of pediatric cancer treatment that is suggested to increase the risk of chronic kidney disease (CKD). Children with a kidney tumor may be at particular risk. This study aimed to determine the incidence and risk factors of AKI and its association with CKD during pediatric kidney tumor treatment.METHODS: We analyzed data from a prospective national cohort of patients ≤ 18 years old diagnosed with a kidney tumor between 2015 and 2021 in the Princess Máxima Center for Pediatric Oncology in the Netherlands. AKI was defined according to KDIGO criteria. CKD was assessed 1 year post-treatment based on proteinuria and/or decreased estimated glomerular filtration rate (eGFR).RESULTS: Of 147 patients, we observed AKI in 104 patients (71%) during therapy. AKI occurred most often within 48 h after tumor nephrectomy (88/104), while the rest had non-nephrectomy-related AKI from multifactorial causes. Sixteen patients experienced more than one AKI episode, and 92/104 episodes were reversible. Patients who developed AKI had a higher eGFR prior to surgery compared to those who did not develop AKI. CKD was observed in 16/120 patients (13%). Risk factors for developing CKD included the occurrence of at least 1 AKI event, the use of a > 3-drug regimen, and a lower eGFR at the start of treatment.CONCLUSION: The high incidence of AKI and its association with early CKD highlights the need for early detection, prevention, and intervention strategies during pediatric kidney tumor treatment.
KW - Acute kidney injury
KW - Chronic kidney disease
KW - Kidney tumors
KW - Wilms tumor
UR - http://www.scopus.com/inward/record.url?scp=85217919458&partnerID=8YFLogxK
U2 - 10.1007/s00467-025-06684-7
DO - 10.1007/s00467-025-06684-7
M3 - Article
C2 - 39966140
SN - 0931-041X
VL - 40
SP - 2393
EP - 2401
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 7
ER -