Treatments and outcomes for end-stage renal disease following Wilms tumor

Yevgeny Grigoriev, Jane Lange, Susan M. Peterson, Janice R. Takashima, Michael L. Ritchey, Dicken Ko, James H. Feusner, Robert C. Shamberger, Daniel M. Green, Norman E. Breslow

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Background Little is known about treatment outcomes for children who have end-stage renal disease (ESRD) after treatment for Wilms tumor (WT). Methods Time-to-transplant, graft failure, and survival outcomes were examined for 173 children enrolled on the National Wilms Tumor Study who developed ESRD. Results Fifty-five patients whose ESRD resulted from progressive bilateral WT (PBWT) experienced high early mortality from WT that limited their opportunity for transplant (47% at 5 years) and survival (44% at 10 years) in comparison to population controls. The 118 patients whose ESRD was due to other causes (termed "chronic kidney disease"), many of whom had WT-associated congenital anomalies, had transplant (77% at 5 years) and survival (73% at 10 years) outcomes no worse than those for population controls. Graft failure following transplant was comparable for the two groups. Minority children had twice the median time to transplant as non-Hispanic whites and twice the mortality rates, also reflecting population trends. Conclusions In view of the continuing high mortality in patients with ESRD, and the dramatic improvement in outlook following kidney transplantation, re-evaluation of current guidelines for a 2-year delay in transplant following WT treatment may be warranted.

Original languageEnglish (US)
Pages (from-to)1325-1333
Number of pages9
JournalPediatric Nephrology
Volume27
Issue number8
DOIs
StatePublished - Aug 2012
Externally publishedYes

Keywords

  • Chronic kidney failure
  • Graft failure
  • Transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Nephrology

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