Acute kidney injury during treatment of pediatric brain tumors: a retrospective analysis of survivors.
In a retrospective cohort of 123 pediatric CNS tumor survivors, only 41 had sufficient creatinine data to assess acute kidney injury, 12 of whom developed AKI; chemotherapy exposure was associated with higher AKI incidence, and chronic kidney impairment was reported in survivorship.
Open original publication →What the AI sees
In a retrospective cohort of 123 pediatric CNS tumor survivors, only 41 had sufficient creatinine data to assess acute kidney injury, 12 of whom developed AKI; chemotherapy exposure was associated with higher AKI incidence, and chronic kidney impairment was reported in survivorship.
Research significance
The record supports AKI as a potential marker of later kidney impairment and identifies inadequate creatinine monitoring as a detection gap; it is reasonable—but untested here—to hypothesize that systematic renal surveillance and targeted preventive measures during and after CNS tumor therapy could reduce or enable earlier management of kidney toxicity.
Source abstract
BACKGROUND: Pediatric cancer survivors are at risk of short- and long-term complications from cancer treatment, including acute kidney injury (AKI) and chronic kidney disease (CKD). Our aims were to assess AKI incidence, examine potential risk factors for AKI during pediatric central nervous system (CNS) tumor treatment, and evaluate for kidney function impairment in survivorship. We hypothesized that any chemotherapy exposure and burden would be associated with higher risk of AKI. METHODS: We reviewed medical records of pediatric CNS tumor survivors treated between 2007 and 2015. The primary outcome was AKI frequency during cancer treatment. Secondary outcomes were severe AKI (sAKI) occurrence during treatment and presence of chronic kidney injury markers (estimated glomerular filtration rate <90 ml/min/1.73m2 or proteinuria) 5+ years beyond treatment completion. RESULTS: 123 patients received CNS tumor treatment during the study period. Out of 41 patients with sufficient serum creatinine (SCr) data available to assess for AKI, 12 had AKI. Chemotherapy exposure was associated with a higher AKI incidence. Fifty-six percent of patients had chronic kidney impairment during survivorship. CONCLUSION: Acute and chronic kidney injury are common in patients with CNS tumors, but detection is limited by heterogeneity of tumor type and adequate SCr availability. IMPACT: Acute kidney injury (AKI) is common during treatment of pediatric tumors of the central nervous system. AKI detection is limited by low availability of adequate serum creatinine measurements in high-risk patients. This longitudinal cohort links AKI presence during cancer treatment with chronic kidney disease during survivorship. Identifying AKI as a CKD risk factor can inform preventive measures and improve monitoring strategies.