Renal complications in children with malignancies: single-centre experience

Abstract

Background and aim of the work: Renal complications in cancer patients are serious and may cause more morbidity and mortality. Acute renal dysfunction may affect optimal cancer treatment by requiring a decrease in chemotherapy dosage or by contraindicating potentially curative treatment. Our study aimed to evaluate different types of renal involvement before and after treatment of childhood malignancies.

Patients and Methods: All oncology patients at Mansoura University Children's Hospital diagnosed with different types of malignancies in seven years period (January 2003 to December 2009) were retrospectively reviewed for renal involvement before or after treatment.

Results: We evaluated 954 pediatric patients with different types of malignancies. Patients encountered renal involvement were 152 (15.9%). A total of 105 patients diagnosed with acute renal failure (ARF), 18 had renal masses, 3 had nephrotic syndrome and 26 had hemorrhagic cystitis.

As regard outcome of acute renal failure, 70 patients (66.7%) showed complete recovery of renal function, while 27 patients died (25.7%). The remaining 8 patients (7.6%) were maintained on chronic replacement therapy.

Conclusions: Renal involvement in children with cancer is a common problem. ARF is the commonest renal complication and most severe. It results from various causes. Early prediction and anticipation of renal insult and prompt management may reduce the risk of renal injury. All oncologists should keep in mind that they are not treating cancer only, but they are treating patient with cancer and should save the kidney as much as possible.