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Pediatr Nephrol. 2012 Aug;27(8):1325-33. doi: 10.1007/s00467-012-2140-x. Epub 2012 Mar 20.

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

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1
Department of Biostatistics and Bioinformatics, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

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.

PMID:
22430485
PMCID:
PMC3383943
DOI:
10.1007/s00467-012-2140-x
[Indexed for MEDLINE]
Free PMC Article
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