Lange, Jane and Peterson, Susan M. and Takashima, Janice R. and Grigoriev, Yevgeny and Ritchey, Michael L. and Shamberger, Robert C. and Beckwith, Bruce and Perlman, Elizabeth and Green , Daniel M. and Breslow, Norman E. (2011) Risk Factors for End Stage Renal Disease in Non-WT1-Syndromic Wilms Tumor. The Journal of Urology , 186 (2). pp. 378-386. ISSN 0022-5347
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Abstract
PURPOSE: We assessed risk factors for end stage renal disease in patients with Wilms tumor without known WT1 related syndromes. We hypothesized that patients with characteristics suggestive of a WT1 etiology (early onset, stromal predominant histology, intralobar nephrogenic rests) would have a higher risk of end stage renal disease due to chronic renal failure. We predicted a high risk of end stage renal disease due to progressive bilateral Wilms tumor in patients with metachronous bilateral disease. MATERIALS AND METHODS: End stage renal disease was ascertained in 100 of 7,950 nonsyndromic patients enrolled in a National Wilms Tumor Study during 1969 to 2002. Risk factors were evaluated with cumulative incidence curves and proportional hazard regressions. RESULTS: The cumulative incidence of end stage renal disease due to chronic renal failure 20 years after Wilms tumor diagnosis was 0.7%. For end stage renal disease due to progressive bilateral Wilms tumor the incidence was 4.0% at 3 years after diagnosis in patients with synchronous bilateral Wilms tumor and 19.3% in those with metachronous bilateral Wilms tumor. For end stage renal disease due to chronic renal failure stromal predominant histology had a HR of 6.4 relative to mixed (95% CI 3.4, 11.9; p<0.001), intralobar rests had a HR of 5.9 relative to no rests (95% CI 2.0, 17.3; p=0.001), and Wilms tumor diagnosis at less than 24 months had a HR of 1.7 relative to 24 to 48 months and 2.8 relative to greater than 48 months (p=0.003 for trend). CONCLUSIONS: Metachronous bilateral Wilms tumor is associated with high rates of end stage renal disease due to surgery for progressive Wilms tumor. Characteristics associated with a WT1 etiology markedly increased the risk of end stage renal disease due to chronic renal failure despite the low risk in non-WT1 syndromic cases overall.
| Item Type: | Article or Abstract |
|---|---|
| DOI: | 10.1016/j.juro.2011.03.110 |
| PubMed ID: | 21683387 |
| PMCID: | PMC3133859 |
| Keywords or MeSH Headings: | Child, Preschool Genes, Wilms Tumor Humans Infant Kidney Failure, Chronic/epidemiology* Kidney Failure, Chronic/etiology* Kidney Neoplasms/complications* Kidney Neoplasms/genetics Risk Factors Wilms Tumor/complications* Wilms Tumor/genetics |
| Depositing User: | Library Staff |
| Date Deposited: | 15 Dec 2010 21:30 |
| Last Modified: | 14 Feb 2012 14:43 |
| URI: | http://authors.fhcrc.org/id/eprint/467 |
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