Cancer and its treatment may lead to kidney injury and the need for kidney replacement therapy (KRT). We identified 287 pediatric KRT patients with a history of malignancy from the European Society for Paediatric Nephrology/European Renal Association Registry. Of these, 197 had cancer as a primary cause of KRT (group 1) and 90 had a malignancy diagnosis before KRT (group 2). Two matched controls without malignancy were randomly selected for each patient. Data were complemented with a questionnaire. Median time to kidney transplantation (KT) from KRT initiation was 2.4 (IQR: 1.5-4.7), 1.5 (IQR: 0.4-3.3), 3.6 (IQR: 1.3 to Q3 not reached), and 1.1 (IQR: 0.3-3.6) years for group 1, their controls, group 2, and their controls, respectively. Overall 10-year mortality for those on KRT was higher among cancer patients vs controls in group 1: 16% vs 9% (adjusted hazard ratio 2.02, 95% CI: 1.21-3.37) and in group 2: 23% vs 14% (adjusted hazard ratio 2.32, 95% CI: 1.11-4.85). In contrast, 10-year patient survival after the first KT was comparable to controls (93% vs 96%; 100% vs 94%, in groups 1 and 2, respectively). In summary, childhood cancer survivors’ KT was delayed, and their overall mortality when on KRT was increased, but once transplanted, their long-term outcome was similar to other KT recipients.

中文翻译：

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儿童癌症后儿童肾脏替代疗法的临床结局 — ESPN/ERA Registry 研究


癌症及其治疗可能导致肾损伤和需要肾脏替代疗法 （KRT）。我们从欧洲儿科肾脏病学会/欧洲肾脏协会登记处确定了 287 例有恶性肿瘤病史的儿科 KRT 患者。其中，197 例癌症是 KRT 的主要原因 （第 1 组），90 例在 KRT 之前被诊断为恶性肿瘤 （第 2 组）。为每位患者随机选择两个匹配的无恶性肿瘤对照。数据由问卷补充。第 1 组、对照组、第 2 组和对照组从 KRT 开始到肾移植 （KT） 的中位时间为 2.4 （IQR： 1.5-4.7）、1.5 （IQR： 0.4-3.3）、3.6 （IQR： 1.3 至 Q3 未达到）和 1.1 （IQR： 0.3-3.6） 年。癌症患者接受 KRT 的患者总体 10 年死亡率高于对照组，第 1 组：16% 对 9%（调整后风险比 2.02,95% CI：1.21-3.37）和第 2 组：23% 对 14%（调整后风险比 2.32,95% CI：1.11-4.85）。相比之下，第一次 KT 后的患者 10 年生存率与对照组相当（第 1 组和第 2 组分别为 93% 对 96%;100% 对 94%）。总之，儿童癌症幸存者的 KT 延迟，他们在接受 KRT 时的总体死亡率增加，但一旦移植，他们的长期结果与其他 KT 接受者相似。