Abstract: FR-PO415
Risk Factors for Long-Term Kidney Outcomes in Childhood Cancer Survivors
Session Information
- Pediatric Nephrology - I
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Authors
- Jain, Anshika, The Hospital for Sick Children, Toronto, Ontario, Canada
- Chui, Hayton, The Hospital for Sick Children, Toronto, Ontario, Canada
- Nunes, Sophia, The Hospital for Sick Children, Toronto, Ontario, Canada
- Farma, Simrandeep, The Hospital for Sick Children, Toronto, Ontario, Canada
- Zappitelli, Michael, The Hospital for Sick Children, Toronto, Ontario, Canada
Group or Team Name
- The first and second authors contributed equally to this work.
Background
Childhood cancer survivor (CCS) follow-up guidelines are unclear on how to risk-stratify for and ascertain long-term kidney outcomes (KO). We evaluated the relation of patient/treatment factors with KO in CCS up to 4 years post-therapy.
Methods
Prospective, national data (secondary use: Cancer in Young People in Canada database; CCS, ≤15-years-old at cancer diagnosis post Jan 1, 2001; 17 centers). Excluded: no birth date/sex; died on treatment. Outcome: KO (included hypertension, nephritis, Fanconi syndrome, CKD, AKI, fluid retention, kidney atrophy, high creatinine, low GFR, kidney stone/abscess, thrombotic microangiopathy; selection adjudicated by two authors). Univariable and multivariate logistic regression was used to evaluate independent risk factors for KO.
Results
18,065 CCS included (178 with KO [1%] vs. 17,818 no KO). Age(p=0.42), sex(p=0.96), ethnicity(p=0.41), income quintile(p=0.46), main cancer diagnosis(p<0.001), abdominal radiation during therapy p=0.66), graft vs. host disease (GVHD) (p<0.004), number of hematopoietic stem cell transplants (HSCT)(p<0.001), center geography(p<0.001) and home distance from center(p=0.54) were evaluated in univariable analyses for association with KO. Adjusted analyses(Fig): More HSCT and kidney or hepatic tumor (vs. leukemia/lymphoma) were associated with higher adjusted odds of KO; East/West Canada (vs. Central) and other cancer diagnoses (shown, Fig) were associated with lower adjusted odds of KO.
Conclusion
Number of HSCT and cancer type are associated with KO in CCS. KO recording is suboptimal, speaking to lack of awareness and unclear CCS kidney health guidelines. We will use our data to initiate knowledge translation with child oncology stakeholders, explore barriers/facilitators to kidney health monitoring and improve current follow-up guidelines.