Abstract 6381: Long-term kidney function after treatment for unilateral, non-metastatic, non-syndromic Wilms tumor. A report from the St. Jude Lifetime Cohort Study
Authors: Green Daniel M. , Wang Mingjuan , Krasin Matthew J. , Davidoff Andrew M. , Srivastava DeoKumar , Jay Dennis W. , Ness Kirsten K. , Shulkin Barry L. , Lanctot Jennifer Q. , Shelton Kyla C. , Brennan Rachel C. , Ehrhardt Matthew J. , Dixon Stephanie , Kurt Beth A. , Robison Leslie L. , Hudson Melissa M. , Spunt Sheri L. 
Published: March 2024

Background: We previously reported that the estimated glomerular filtration rate (eGFR) was decreased among survivors of unilateral, non-metastatic, non-syndromic Wilms tumor (WT) treated with whole abdomen radiation therapy (WART) compared to controls, but not compared to unirradiated WT survivors (Pediatr Blood Cancer 2020;67:e28271). The impact of sex on estimates of kidney function among adult survivors of WT has not been well-documented.

Methods: We clinically evaluated male and female WT survivors with creatinine and cystatin C, calculated eGFR using the Chronic Kidney Disease - Epidemiology (CKD-EPI) equations with and without cystatin C and measured 99mTc diethylenetriamine pentaacetic acid (DTPA) plasma clearance. WT survivors consisted of 20 treated with unilateral nephrectomy (UN), non-nephrotoxic chemotherapy (NNC) and whole abdomen radiation therapy (WART) (mean - 20.2 Gray (Gy); standard deviation (SD) - 9.12 Gy), and 20 treated with UN, no radiation therapy, and NNC. Correlations between 99mTc DTPA clearance and eGFR were calculated.

Results: Among female WT survivors, none of the eGFR calculations was statistically significantly correlated with 99mTc DTPA clearance. Among male WT survivors, 99mTc DTPA clearance correlated well with eGFR calculations that included creatinine. Results are shown in the Table.

Conclusions: Among female survivors of unilateral, non-metastatic, non-syndromic WT who have undergone UN, eGFR is poorly correlated with 99mTc DTPA clearance. Evaluation of treatment-related changes in body composition may provide insight into these results.

Correlation between eGFR and 99mTc DTPA clearance Females eGFR(CKD-EPI) 99mTc DTPA clearance No radiation therapy (n=13) Whole abdomen radiation therapy(n=12) Pearson correlation coefficient p-value Pearson correlation coefficient p-value Creatinine only 0.109 0.723 -0.295 0.352 Cystatin C only 0.311 0.301 0.094 0.782 Creatinine and cystatin C 0.348 0.244 -0.028 0.935 Males No radiation therapy (n=6) Whole abdomen radiation therapy(n=6) Pearson correlation coefficient p-value Pearson correlation coefficient p-value Creatinine only 0.827 0.043 0.859 0.028 Cystatin C only 0.811 0.050 0.592 0.216 Creatinine and cystatin C 0.878 0.021 0.866 0.026

Citation Format: Daniel M. Green, Mingjuan Wang, Matthew J. Krasin, Andrew M. Davidoff, DeoKumar Srivastava, Dennis W. Jay, Kirsten K. Ness, Barry L. Shulkin, Jennifer Q. Lanctot, Kyla C. Shelton, Rachel C. Brennan, Matthew J. Ehrhardt, Stephanie Dixon, Beth A. Kurt, Leslie L. Robison, Melissa M. Hudson, Sheri L. Spunt. Long-term kidney function after treatment for unilateral, non-metastatic, non-syndromic Wilms tumor. A report from the St. Jude Lifetime Cohort Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6381.