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儿童和年轻成人癌症幸存者的肾功能与低分子量蛋白质(胱抑素C、β2-微球蛋白、中性粒细胞明胶酶相关脂质运载蛋白)

Renal function and low-molecular-weight proteins (cystatin C, β2-microglobulin, neutrophil gelatinase-associated lipocalin) in child and young adult cancer survivors.

作者信息

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

机构信息

Department of Pediatrics, Hematology, Oncology, Endocrinology, Medical University of Gdansk, Bydgoszcz, Poland.

出版信息

J Pediatr Hematol Oncol. 2012 Aug;34(6):461-6. doi: 10.1097/MPH.0b013e318257fd89.

Abstract

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.

摘要

背景

我们试图验证这一假设,即完成治疗的癌症儿童和青年因肾损伤的类型和程度不同而存在差异。

程序

本研究纳入了144名完成白血病和淋巴瘤治疗的儿童和青年(73名女性)(L组,n = 45)、肾母细胞瘤患者(W组,n = 52)和其他实体瘤患者(S组,n = 47)。评估了以下参数:血清肌酐、胱抑素C、β2-微球蛋白、中性粒细胞明胶酶相关脂质运载蛋白的浓度以及白蛋白尿排泄量,并进行了尿沉渣分析。使用经典的施瓦茨公式(eGFRSch)、简化施瓦茨公式(eGFRSchred)和菲勒公式(eGFRFiller)以及慢性肾脏病患者的新施瓦茨方程(eGFRSchCKD)估算肾小球滤过率(eGFR)。

结果

与L组和W组相比,S组的eGFRSchCKD和eGFRFiller最低,血清胱抑素C最高,白蛋白排泄量也最高。与L组相比,S组和W组的eGFRSch和eGFRSchred较低,血清β2-微球蛋白和中性粒细胞明胶酶相关脂质运载蛋白较高。W组的eGFRSchCKD低于L组。

结论

完成治疗的癌症儿童和青年所遭受的肾损伤类型和程度存在差异。

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