Kazama Takuro, Nio Masaki, Sasaki Hideyuki, Fukuzawa Taichi, Sato Tomoyuki
Department of Pediatric Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Surgery, Miyagi Children's Hospital, Aoba, Sendai, Japan.
Pediatr Int. 2018 Oct;60(10):962-965. doi: 10.1111/ped.13661. Epub 2018 Oct 15.
The aim of this study was to assess long-term residual kidney function after unilateral nephrectomy for non-syndromic Wilms tumor (NSWT).
Of the patients who underwent one-sided NSWT at Tohoku University Hospital between 1977 and 2003, nine were followed up until age ≥18 years. For these nine patients, we retrospectively evaluated estimated glomerular filtration rate (eGFR) in childhood (3-10 years old), adolescence (11-17 years old) and adulthood (≥18 years).
Mean age at the last follow up was 23.0 years. Tumor classification was as follows: stage I tumor, n = 6; stage II tumor, n = 3; mixed-type nephroblastoma, n = 8; and congenital mesoblastic nephroma, n = 1. Mean eGFR was 101.3 ± 21.2 mL/min/1.73 m in childhood, 106.0 ± 32.1 mL/min/1.73 m in adolescence and 100.5 ± 20.7 mL/min/1.73 m in adulthood. Therefore, no significant change in eGFR was observed over the three life stages evaluated. Further, none of the patients met the diagnostic criteria for chronic kidney disease by early adulthood.
eGFR after unilateral nephrectomy in patients with NSWT remained ≥60 mL/min/1.73 m during the transition from childhood to early adulthood, with no development of chronic kidney disease or end-stage kidney failure.
本研究旨在评估非综合征性肾母细胞瘤（NSWT）单侧肾切除术后的长期残余肾功能。
在1977年至2003年间于东北大学医院接受单侧NSWT手术的患者中，9例被随访至年龄≥18岁。对于这9例患者，我们回顾性评估了其在儿童期（3 - 10岁）、青春期（11 - 17岁）和成年期（≥18岁）的估计肾小球滤过率（eGFR）。
末次随访时的平均年龄为23.0岁。肿瘤分类如下：I期肿瘤，n = 6；II期肿瘤，n = 3；混合型肾母细胞瘤，n = 8；先天性中胚叶肾瘤，n = 1。儿童期的平均eGFR为101.3 ± 21.2 mL/min/1.73 m²，青春期为106.0 ± 32.1 mL/min/1.73 m²，成年期为100.5 ± 20.7 mL/min/1.73 m²。因此，在所评估的三个生命阶段中，eGFR未观察到显著变化。此外，到成年早期，没有患者符合慢性肾脏病的诊断标准。
NSWT患者单侧肾切除术后的eGFR在从儿童期到成年早期的过渡期间保持≥60 mL/min/1.73 m²，未发生慢性肾脏病或终末期肾衰竭。
