Key result
Childhood cancer survivors given nephrotoxic therapies show comparable hypertension to controls with ~8% masked hypertension.
Why the study?
The study was conducted to evaluate the prevalence of and risk factors for hypertension in childhood cancer survivors treated with potentially nephrotoxic therapies.
What is the prevalence of and risk factors for hypertension in long-term childhood cancer survivors treated with potentially nephrotoxic therapies compared to controls?
Observational
What is the prevalence of and risk factors for hypertension in long-term childhood cancer survivors treated with potentially nephrotoxic therapies compared to controls?
Effect estimate: OR 3.4 (95% CI 1.4-8.5)
Long-term childhood cancer survivors treated with nephrotoxic therapies have a comparable prevalence of hypertension to controls, but face specific risks from abdominal radiotherapy and total body irradiation, with some cases remaining undiagnosed without ambulatory monitoring.
Standard screening may miss masked hypertension in survivors; leaves open radiotherapy-specific risks pending prospective confirmation.
PURPOSE: To evaluate the prevalence of and risk factors for hypertension in childhood cancer survivors (CCSs) who were treated with potentially nephrotoxic therapies. METHODS: total) or haematopoietic stem cell transplantation participated and 500 controls from Lifelines. Hypertension was defined as blood pressure (BP) (mmHg) systolic ≥140 and/or diastolic ≥90 or receiving medication for diagnosed hypertension. At the study visit, the CKD-EPI 2012 equation including creatinine and cystatin C was used to estimate the glomerular filtration rate (GFR). Multivariable regression analyses were used. For ambulatory BP monitoring (ABPM), hypertension was defined as BP daytime: systolic ≥135 and/or diastolic ≥85, night time: systolic ≥120 and/or diastolic ≥70, 24-h: systolic ≥130 and/or diastolic ≥80. Outcomes were masked hypertension (MH), white coat hypertension and abnormal nocturnal dipping (aND). RESULTS: ) was associated with hypertension in CCS (OR 3.4, 95% CI 1.4-8.5). Risk factors were abdominal radiotherapy ≥20 Gy and TBI. The ABPM-pilot study (n = 77) showed 7.8% MH, 2.6% white coat hypertension and 20.8% aND. CONCLUSION: The prevalence of hypertension was comparable among CCS who were treated with potentially nephrotoxic therapies compared to controls, some of which were undiagnosed. Risk factors were abdominal radiotherapy ≥20 Gy and TBI. Hypertension and decreased GFR were associated with CCS. ABPM identified MH and a ND.
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Kooijmans et al. (2022) conducted an observational in Childhood cancer survivors. Potentially nephrotoxic therapies vs. Controls from Lifelines was evaluated on Hypertension (systolic ≥140 and/or diastolic ≥90 mmHg or receiving medication) (OR 3.4, 95% CI 1.4-8.5). Childhood cancer survivors treated with nephrotoxic therapies had comparable hypertension prevalence to controls, while an ABPM pilot identified 7.8% with masked hypertension.
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