Association between Wilms tumor and chronic renal failure: an integrative literature review

Keywords

Wilms tumor - kidney neoplasms - chronic renal insufficiency

Introduction: Wilms tumor (WT), or nephroblastoma, is a common kidney cancer in children. Despite advances in treatment, chronic kidney disease (CKD) remains a relevant complication. CKD can result both from the impact of the kidney tumor and from the adverse effects of treatments, such as nephrectomy, chemotherapy and radiotherapy. Due to this occurrence of CKD in WT survivors, it is important to develop effective prevention and management strategies to improve the quality of life in these patients.

Objectives: To investigate the prevalence of CKD in patients with WT, exploring its pathophysiological mechanisms, treatments, and complications, and identify risk factors and potential sequelae.

Methodology: This study consists of an integrative literature review. Data collection was carried out through an electronic search on the PubMed platform. The descriptors taken from DeCS and MeSH were used: “Wilms Tumor” and “Chronic Renal Insufficiency”, including works published in the last 10 years (2014-2024), resulting in 14 works. Among these, 6 studies were considered more pertinent to the theme and used as a reference to the Glomerular Filtration Rate (GFR), protein excretion and blood pressure of each patient.

Results: The integrative analysis of the literature allows us to conclude that after the treatment of childhood tumors there is, in the long term, an impairment of renal function in adult life. One of the studies followed patients with a mean age of 11.7 years, in which 62% had at least one renal sequela, 39% had CKD, 23% had albuminuria and 21% had an increase in blood pressure. Another study carried out with patients surviving WT with a mean age of 28.7 years showed that of the 37 participants, 24.3% had CKD stage II or higher and were associated with high blood pressure.

Conclusion: The results show the occurrence of CKD in approximately one third of patients associated with albuminuria and hypertension. Therefore, in addition to continuous monitoring of the renal and cardiovascular health of survivors, it is necessary to consider nephron-sparing surgery as a therapeutic possibility for patients with WT, in order to avoid the development of CKD or other associated complications, reduce the incidence of surgical margins positive results and provide a better prognosis for the patient.

Corresponding author: Larissa Maria Moraes Rodrigues de Souza (e-mail: [e-mail]).

 

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Artikel online veröffentlicht:
06. Mai 2025