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The kidneys are vital organs that filter waste products from the blood, control blood pressure, and stimulate red blood cell production. Treatment for children's cancer can sometimes damage the kidneys. Some kidney problems occur during therapy and persist, while others can begin years after completion of therapy.
Survivors who have received any of the above treatments should have yearly check-ups that include tests for kidney function and blood pressure. These may include urine and blood tests to look at kidney function and measure salts and minerals. Sometimes specialized X-rays are needed to better study kidney function. Healthcare providers may refer patients to a nephrologist or urologist (kidney or bladder specialist) for additional evaluation.
Summary of recommendations for follow-up
Medical check-up including blood pressure check
Blood tests to check kidney function blood urea nitrogent (BUN)
Blood tests for electrolytes (blood salts and minerals)
First long term follow-up visit*, then every five years
Kidney function test (creatinine clearance or GFR)
First long-term follow-up visit*, repeated periodically if problems are detected
Radiation involving the kidneys
Blood tests to check kidney function (BUN and creatinine)
Blood tests for electrolytes (blood salts and minerals) and kidney function test (creatinine clearance or GFR)
If high blood pressure, protein in the urine, or abnormal BUN or creatinine. Repeat periodically if problems detected.
Cystectomy (also refer to above recommendations)
Check up by urologist
First long-term follow-up visit*
If high blood pressure, protein in the urine or abnormal BUN or creatinine. Repeat periodically if problems detected.
*First long-term follow-up visit should be at least 2 years after completing cancer therapy
For Patients Who Had a Kidney Removed During Cancer Treatment
Treatment for children's cancer sometimes requires removal of one kidney (nephrectomy). Although patients can live a healthy life with only one kidney, it is important that they take steps to protect the remaining kidney in order to keep it as healthy as possible.