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Renal Function and Low–Molecular-Weight Proteins (Cystatin C, β2-Microglobulin, Neutrophil Gelatinase-associated Lipocalin) in Child and Young Adult Cancer Survivors

Stefanowicz, Joanna MD, PhD; Owczuk, Radosław MD, PhD; Aleksandrowicz, Ewa MD, PhD; Owczarzak, Anna MD, PhD; Kurylak, Andrzej MD, PhD; Adamkiewicz-Drożyńska, Elżbieta MD, PhD; Balcerska, Anna MD, PhD

Journal of Pediatric Hematology/Oncology: August 2012 - Volume 34 - Issue 6 - p 461–466
doi: 10.1097/MPH.0b013e318257fd89
Clinical and Laboratory Observations

Background: We sought to verify the hypothesis that children and young adults with cancer who have completed treatment differ according to the type and degree of renal damage.

Procedure: This study included 144 children and young adults (73 female) who had completed treatment for leukemias and lymphomas (group L, n=45), Wilms tumor (group W, n=52) and other solid tumors (group S, n=47). The following parameters were evaluated: serum concentrations of creatinine, cystatin C, β2-microglobulin, neutrophil gelatinase-associated lipocalin and urine excretion of albumin, and urinalysis with sediment. Glomerular filtration rate (eGFR) was estimated using the classic Schwartz (eGFRSch), Schwartz redux (eGFRSchred), and Filler (eGFRFiller) formulas and with the new Schwartz equation for patients with chronic kidney disease (eGFRSchCKD).

Results: Group S had the lowest eGFRSchCKD and eGFRFiller, the highest serum cystatin C and the highest albumin excretion compared with groups L and W. Groups S and W had lower eGFRSch and eGFRSchred and higher serum β2-microglobulin and neutrophil gelatinase-associated lipocalin compared with group L. Group W had lower eGFRSchCKD than group L.

Conclusions: Children and young adults with cancer who have completed treatment differ in the type and degree of renal damage they sustain.

Departments of *Pediatrics, Hematology, Oncology, Endocrinology

Anesthesiology and Intensive Therapy

Clinical Nutrition and Laboratory Diagnostics, Medical University of Gdansk

§Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

The authors declare no conflict of interest.

Reprints: Joanna Stefanowicz, MD, PhD, Department of Pediatrics, Hematology, Oncology, Endocrinology, Medical University of Gdansk, 7 Debinki Street, 80-952 Gdansk, Poland (e-mail:

Received June 15, 2011

Accepted March 29, 2012

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.