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Abstract: TH-OR30

Prevalence and Persistence of CKD and Hypertension 36 Months Post-Cisplatin in Children

Session Information

Category: Pediatric Nephrology

  • 1800 Pediatric Nephrology

Authors

  • McMahon, Kelly, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
  • Iyengar, Yajur, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada
  • Lebel, Asaf, SickKids Research Institute, Toronto, Ontario, Canada
  • Cockovski, Vedran, SickKids Research Institute, Toronto, Ontario, Canada
  • Wang, Stella Qiongbin, SickKids Research Institute, Toronto, Ontario, Canada
  • Zappitelli, Michael, SickKids Research Institute, Toronto, Ontario, Canada

Group or Team Name

  • ABLE Nephrotoxicity Group
Background

Long-term kidney outcomes in children treated with Cisplatin(CisP) are unclear. We 1)estimated low eGFR and elevated BP or hypertension(eBP-HT) prevalence 36 months(m) post- pediatric CisP therapy; 2) determined if a)AKI during CisP and b)3m and 12 m kidney and BP status were associated with 36m low eGFR and eBP-HT.

Methods

12 Canadian-site 36m prospective cohort study of CisP-treated children. Exposures: a) AKI during CisP therapy (KDIGO serum creatinine criteria); b) 3m and 12m low eGFR (<90ml/min/1.73m2) and eBP-HT. 36m outcomes: a) low eGFR; eBP-HTN. Univariate tests and logistic regression (odds ratios [OR], 95% CI) were used to evaluate exposure-outcome associations.

Results

101 participants (51.5% girls, median[IQR] age 4.4[2.4-9.2]) included. 36m post CisP: 16/85(18.8%) had low eGFR; 26/88(29.6%) had eBP-HT; 38/79 patients(48.1%) had low eGFR or eBP-HT. Table 1 shows characteristics by outcomes. AKI was associated with 36m composite low eGFR or eBP-HTN (AKI: 23/38[60.5%]; no AKI: 15/38[39.5%], p<0.05). Low eGFR at 3m and 12m post-CisP were associated with 36m low eGFR (OR[95% CI]: 17.5[1.7-183]; 16[1.5-167], respectively, Table 1). 12m eBP-HT was associated with 36m eBP-HT (OR [95% CI] 4[1.4-11.8], Table 1). 12m low eGFR or eBP-HT was associated with 36m low eGFR or eBP-HT (OR [95% CI] 3.0 [1.1-8.3]).

Conclusion

Low eGFR and high BP are common after CisP and persist from 3m and 12m to 36m. Clear post-CisP kidney health follow-up guidelines must be developed. AKI during therapy may portend worse long-term CisP kidney health.

* p-value <0.05; ** p-value<0.01; # In the month prior to the 36 months’ follow-up visit. Continuous variables expressed as median [interquartile range]; categorical variables expressed as numbers (proportion of total).