RENAL-FUNCTION FOLLOWING UNILATERAL NEPHRECTOMY FOR NEUROBLASTOMA ANDWILMS-TUMOR

To estimate the side effects of chemotherapy and the influence of age at the time of nephrectomy on renal function, we investigated renal fu nction in 34 uninephrectomised children with neuroblastoma (NB) or Wil ms' tumour (WT). The results were compared with 6 controls who underwe nt nephrectomy for non-malignant disease. Study of renal function was primarily based on the clearance of inulin and para-aminohippuric acid C-in and C-PAH, ml/min per 1.73 m(2)). No significant differences in C-in/C-PAH (mean +/- SD) were found between the NE group (90 +/- 24/ 4 21 +/- 95), WT group (85 +/- 17/386 +/- 104) and the controls (93 +/- 13/430 +/- 61). Children with NE and WT were divided into two subgroup s according to the theoretical nephrotoxic risk. There was no signific ant difference in renal function between NE or between WT subgroups. C umulative cisplatin doses in children with NE did not affect renal fun ction significantly. The age at time of unilateral nephrectomy (less t han or equal to 2 years vs. > 2 years) was not associated with a highe r risk of renal damage in WT children, whereas in NE children the filt ration fraction (C-in:C-PAH) was higher in younger children (mean +/- SD: 0.243 +/- 0.023 vs. 0.191 +/- 0.041). In conclusion, uninephrectom ised children with NE are supposed to have a higher risk of drug-induc ed renal impairment compared with those with WT. Our data do not confi rm this hypothesis, since renal function was comparable to controls in both groups, except in younger patients with NE who show a high filtr ation fraction. Since the survival of children with NE has improved, a longer follow-up of their renal function in needed.