WASHINGTON, DC USA (UroToday.com) - Drs. Michael Ritchey and Dr. Jeff Dome discussed the excellent outcomes with respect to NWTS-5 survival data but addressed late effects of the treatment for Wilm's tumor.
Possible causes of renal failure in children with treated Wilms tumor include: decreased renal mass and subsequent hyperfiltration injury, radiation nephritis, chemotherapy-induced nephropathy, vascular injury and medical renal disease. In children with unilateral Wilm's tumor, the most common etiology of the renal failure is Denys-Drash syndrome and children with WAGR (aniridia) also at an increased risk. Males with other GU anomalies also had an increased risk of renal failure.
It appears that WT-1 abnormalities increase the risk of renal failure. Other risk factors identified included younger age, stromal histology and intralobar nephrogenic rests, with stromal histology shown to be the greatest risk factor in multivariate analysis.
Presented by Michael Ritchey, MD at the 59th Annual Meeting of the Society for Pediatric Urology during the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Pamela I. Ellsworth, MD, Associate Professor Surgery (Urology), Alpert Medical School of Brown University.