Kidney Week

Abstract: SA-PO203

Extent of Screening for CKD Development and Monitoring for CKD Complications in Childhood Cancer Survivors: A Single-Centre Retrospective Cohort Study

Session Information

• Onconephrology: Kidney Outcomes during Cancer Treatment and Nephropathies
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1700 Onconephrology

Authors

• Sun, Carolyn, The Hospital for Sick Children, Toronto, Ontario, Canada

Carolyn Sun, MSc

• Rubenstein, David Ari, The Hospital for Sick Children, Toronto, Ontario, Canada

David Ari Rubenstein

• Mannan, Mahmudul, The Hospital for Sick Children, Toronto, Ontario, Canada

Mahmudul Mannan, MD, MBBS

• Nathan, Paul, The Hospital for Sick Children, Toronto, Ontario, Canada

Paul Nathan, MD, MS

• Schechter, Tal, The Hospital for Sick Children, Toronto, Ontario, Canada

Tal Schechter, MD

• Yip, Brandon, The Hospital for Sick Children, Toronto, Ontario, Canada

Brandon Yip, MPH

• Mata, Anisa, The Hospital for Sick Children, Toronto, Ontario, Canada

Anisa Mata, MSc

• Haddad, Sham, The Hospital for Sick Children, Toronto, Ontario, Canada

Sham Haddad, MMSc

• Hejri-Rad, Yasmine, The Hospital for Sick Children, Toronto, Ontario, Canada

Yasmine Hejri-Rad

• Cockovski, Vedran, The Hospital for Sick Children, Toronto, Ontario, Canada

Vedran Cockovski

• Wang, Stella Qiongbin, The Hospital for Sick Children, Toronto, Ontario, Canada

Stella Qiongbin Wang, MS, MSc

• Zappitelli, Michael, The Hospital for Sick Children, Toronto, Ontario, Canada

Michael Zappitelli, MD, MSc

Background

Childhood cancer survivors (CCS) are at risk for CKD. The extent to which CCS are screened for CKD, or monitored for CKD complications is unknown. We evaluated: 1) the extent of screening for CKD in CCS ≥6 months post-cancer therapy; 2) in patients attaining CKD criteria, the extent of monitoring for CKD complications and of nephrology referral; and 3) the association of patient and cancer characteristics with CKD screening.

Methods

Retrospective cohort study of CCS, ≤18 years at cancer diagnosis from 2016–2020 at a quaternary care referral institution. Outcomes: 1) CKD screening (serum creatinine [SCr] or proteinuria); 2) CKD complications monitoring (i.e., repeat SCr/proteinuria; nephrology referral; vitamin D; PTH; hemoglobin; frequency per KDIGO guideline/CKD severity). CKD defined as: a) “non-strict”: any abnormal result; b) “strict”: ≥2 abnormal results (eGFR or proteinuria); ≥3 months apart; no normal results in between. Associations between characteristics and CKD screening were evaluated using distribution-appropriate univariable analyses.

Results

Of 443 CCS, only 240 (54.2%) and 132 (29.8%) were screened for non-strict and strict CKD, respectively; 41 (17.1%) and 15 (11.4%) attained criteria for non-strict and strict CKD, respectively. In CCS with non-strict and strict CKD respectively, percentages with complications monitoring: SCr measured (92.7%; 100.0%); urine protein measured (76.9%; 86.7%); nephrology referral (54.1%; 61.5%); vitamin D (36.8%; 61.5%); PTH (31.6%; 38.5%); hemoglobin (90.2%; 93.3%). Table: several variables were associated with CKD screening; many are recognized kidney risk factors.

Conclusion

Screening for CKD and monitoring for CKD complications in CCS are not ideal. Kidney guidelines and follow-up in CCS should be improved to reduce CKD and complications.

Funding

• Government Support – Non-U.S.