{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"submitter":["Dieffenbach BV"],"funding":["NCATS NIH HHS","National Cancer Institute","American Lebanese Syrian Associated Charities","St. Jude Children&apos;s Research Hospital","NCI NIH HHS","Memorial Sloan-Kettering Cancer Center"],"pagination":["216-226"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC8429192"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["155"],"pubmed_abstract":["<h4>Background</h4>The incidence of and risk factors for late-onset kidney failure among survivors over the very long term remains understudied.<h4>Materials and methods</h4>A total of 25,530 childhood cancer survivors (median follow-up 22.3 years, interquartile range 17.4-28.8) diagnosed between 1970 and 1999, and 5045 siblings from the Childhood Cancer Survivor Study were assessed for self-reported late-onset kidney failure, defined as dialysis, renal transplantation, or death attributable to kidney disease. Piecewise exponential models evaluated associations between risk factors and the rate of late-onset kidney failure.<h4>Results</h4>A total of 206 survivors and 10 siblings developed late-onset kidney failure, a 35-year cumulative incidence of 1.7% (95% confidence interval [CI] = 1.4-1.9) and 0.2% (95% confidence interval [CI] = 0.1-0.4), respectively, corresponding to an adjusted rate ratio (RR) of 4.9 (95% CI = 2.6-9.2). High kidney dose from radiotherapy (≥15Gy; RR = 4.0, 95% CI = 2.1-7.4), exposure to high-dose anthracycline (≥250 mg/m<sup>2</sup>; RR = 1.6, 95% CI = 1.0-2.6) or any ifosfamide chemotherapy (RR = 2.6, 95% CI = 1.2-5.7), and nephrectomy (RR = 1.9, 95% CI = 1.0-3.4) were independently associated with elevated risk for late-onset kidney failure among survivors. Survivors who developed hypertension, particularly in the context of prior nephrectomy (RR = 14.4, 95% CI = 7.1-29.4 hypertension with prior nephrectomy; RR = 5.9, 95% CI = 3.3-10.5 hypertension without prior nephrectomy), or diabetes (RR = 2.2, 95%CI = 1.2-4.2) were also at elevated risk for late-onset kidney failure.<h4>Conclusions</h4>Survivors of childhood cancer are at increased risk for late-onset kidney failure. Kidney dose from radiotherapy ≥15 Gy, high-dose anthracycline, any ifosfamide, and nephrectomy were associated with increased risk of late-onset kidney failure among survivors. Successful diagnosis and management of modifiable risk factors such as diabetes and hypertension may mitigate the risk for late-onset kidney failure. The association of late-onset kidney failure with anthracycline chemotherapy represents a novel finding that warrants further study."],"journal":["European journal of cancer (Oxford, England : 1990)"],"pubmed_title":["Late-onset kidney failure in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study."],"pmcid":["PMC8429192"],"funding_grant_id":["P30 CA021765","UL1 TR001863","U24 CA055727","CA21765","CA55727"],"pubmed_authors":["Howell RM","Leisenring WM","Smith SA","Yasui Y","Madenci AL","Wu N","Murphy AJ","Liu Q","Dieffenbach BV","Stein DR","Weil BR","Armstrong GT","Chow EJ","Weldon CB","Goldsby RE","Kadan-Lottick NS","Christison-Lagay ER","Oeffinger KC"],"additional_accession":[]},"is_claimable":false,"name":"Late-onset kidney failure in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.","description":"<h4>Background</h4>The incidence of and risk factors for late-onset kidney failure among survivors over the very long term remains understudied.<h4>Materials and methods</h4>A total of 25,530 childhood cancer survivors (median follow-up 22.3 years, interquartile range 17.4-28.8) diagnosed between 1970 and 1999, and 5045 siblings from the Childhood Cancer Survivor Study were assessed for self-reported late-onset kidney failure, defined as dialysis, renal transplantation, or death attributable to kidney disease. Piecewise exponential models evaluated associations between risk factors and the rate of late-onset kidney failure.<h4>Results</h4>A total of 206 survivors and 10 siblings developed late-onset kidney failure, a 35-year cumulative incidence of 1.7% (95% confidence interval [CI] = 1.4-1.9) and 0.2% (95% confidence interval [CI] = 0.1-0.4), respectively, corresponding to an adjusted rate ratio (RR) of 4.9 (95% CI = 2.6-9.2). High kidney dose from radiotherapy (≥15Gy; RR = 4.0, 95% CI = 2.1-7.4), exposure to high-dose anthracycline (≥250 mg/m<sup>2</sup>; RR = 1.6, 95% CI = 1.0-2.6) or any ifosfamide chemotherapy (RR = 2.6, 95% CI = 1.2-5.7), and nephrectomy (RR = 1.9, 95% CI = 1.0-3.4) were independently associated with elevated risk for late-onset kidney failure among survivors. Survivors who developed hypertension, particularly in the context of prior nephrectomy (RR = 14.4, 95% CI = 7.1-29.4 hypertension with prior nephrectomy; RR = 5.9, 95% CI = 3.3-10.5 hypertension without prior nephrectomy), or diabetes (RR = 2.2, 95%CI = 1.2-4.2) were also at elevated risk for late-onset kidney failure.<h4>Conclusions</h4>Survivors of childhood cancer are at increased risk for late-onset kidney failure. Kidney dose from radiotherapy ≥15 Gy, high-dose anthracycline, any ifosfamide, and nephrectomy were associated with increased risk of late-onset kidney failure among survivors. Successful diagnosis and management of modifiable risk factors such as diabetes and hypertension may mitigate the risk for late-onset kidney failure. The association of late-onset kidney failure with anthracycline chemotherapy represents a novel finding that warrants further study.","dates":{"release":"2021-01-01T00:00:00Z","publication":"2021 Sep","modification":"2025-04-04T21:52:29.68Z","creation":"2025-04-04T21:52:29.68Z"},"accession":"S-EPMC8429192","cross_references":{"pubmed":["34391054"],"doi":["10.1016/j.ejca.2021.06.050"]}}