Table 1.
Characteristics of the cohort by CKD and hypertension status at the 3-month visit
| Characteristic | 3-mo Visit | |||
|---|---|---|---|---|
| CKD (n=52) | No CKD (n=66) | HTN (n=17) | No HTN (n=108) | |
| Baseline characteristics | ||||
| Age at cisplatin treatment start, median (IQR), yr | 3 (2–10) | 7 (4–12) | 2 (2–4) | 7 (3–13)k |
| Age at cisplatin treatment start <3 yr, No. (%) | 22 (42) | 13 (20)j | 10 (59) | 25(23)k |
| Male, No. (%) | 29 (56) | 32 (48) | 15 (88) | 49(45)k |
| Race, No. (%) | ||||
| Aboriginal | 2 (4) | 2 (3) | 0 (0.0) | 7 (6) |
| American Indian/Alaskan | 1 (2) | 0 (0.0) | 0 (0.0) | 1 (0.9) |
| White | 42 (81) | 51 (77) | 14 (82) | 79 (73) |
| Black | 1 (2) | 1 (2) | 1 (6) | 3 (3) |
| Asian | 2 (4) | 8 (12) | 1 (6) | 10 (9) |
| Mixed race | 4 (8) | 4 (6) | 1 (6) | 7 (6) |
| Hispanic | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (0.9) |
| Cancer type, No. (%) | ||||
| Osteosarcoma | 8 (15) | 18 (27) | 1 (6) | 29 (27) |
| Germ cell tumor | 4 (8) | 5 (8) | 2 (12) | 7 (6) |
| Neuroblastoma | 17 (33) | 20 (30) | 6 (35) | 23 (21) |
| CNS tumora | 20 (39) | 18 (27) | 6 (35) | 40 (37) |
| Hepatoblastoma | 3 (6) | 3 (5) | 2 (12) | 7 (6) |
| Otherb | 0 (0.0) | 2 (3) | 0 (0.0) | 2 (2) |
| Baseline GFR or eGFR, ml/min per 1.73 m2, mean (SD)c | 155 (45) | 141 (35) | 148 (48) | 138 (39) |
| Low baseline GFR or eGFR for age, No. (%)d | 0 (0.0) | 0 (0.0) | 2 (12) | 5 (5) |
| Kidney medical history, No. (%)e | 6 (12) | 5 (8) | 0 (0.0) | 5 (5) |
| Any nephrotoxic drug prior to first cisplatin, No. (%)f | 12 (23) | 8 (12) | 2 (12) | 19 (18) |
| Vancomycin use before first cisplatin, No. (%) | 4 (8) | 2 (3) | 0 (0.0) | 6 (6) |
| During cisplatin/cancer treatment characteristics | ||||
| Cancer involves one or both kidneys, No. (%) | 7 (13) | 2 (3)j | 1 (6) | 6 (6) |
| Flank (left or right), whole abdomen, or total body radiation given or planned, No. (%) | 6 (12) | 11 (17) | 3 (18) | 12 (11) |
| Total cumulative cisplatin dose, median (IQR), mg/m2 | 349 (254–410) | 396 (294–446) | 355 (240–410) | 394 (283–466) |
| Stem cell transplant in chemotherapy protocol, No. (%) | 29 (56) | 24 (36) | 12 (71) | 35(32)k |
| Infection, No. (%)g | 22 (42) | 20 (30) | 7 (41) | 36 (33) |
| Sepsis, No. (%) | 5 (10) | 0 (0.0)j | 0 (0.0) | 5 (5) |
| Kidney infection or UTI, No. (%)h | 4 (8) | 2 (3) | 3 (18) | 4 (4) |
| PICU admission, No. (%) | 4 (8) | 5 (8) | 4 (24) | 5 (5)j |
| SCr-AKI during treatment, No. (%) | 22 (42) | 28 (42) | 9 (53) | 44 (41) |
| Between last cisplatin infusion and follow-up visit characteristics | ||||
| Nephrectomy, No. (%) | 1 (2) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
| Nephrotoxic drug (in 1 mo prior to follow-up visit), No. (%)i | 27 (52) | 17(26)k | 8 (47) | 41 (38) |
| Acyclovir (in 1 mo prior to follow-up visit), No. (%) | 7 (13) | 7 (11) | 2 (12) | 11 (10) |
| Time between cisplatin treatment end and follow-up visit, median (IQR), d | 88 (71–103) | 85 (75–108) | 85 (70–104) | 91 (80–111) |
| BMI percentile at follow-up visit, median (IQR) | 22 (5–58) | 40 (19–61) | 39 (20–52) | 35 (8–63) |
BMI, body mass index; CNS, central nervous system; HTN, hypertension; IQR, interquartile range; PICU, pediatric intensive care unit; SCr, serum creatinine; UTI, urinary tract infection.
Central nervous system tumors: astrocytoma, choroid plexus tumor, ependymoma, medulloblastoma, primitive neuroectodermal tumor, and atypical teratoid/rhabdoid tumor.
Other cancer: lymphoma and nasopharyngeal carcinoma.
Baseline measured or eGFR was assessed using measured GFR if available or 24-hour creatinine clearance if unavailable; if both were unavailable, GFR was estimated (using the lowest 3-month pre-cisplatin serum creatinine level).
Defined using age-based thresholds: aged ≤1 month, GFR <43 ml/min per 1.73 m2; aged 1–4 months, GFR <47 ml/min per 1.73 m2; aged 4–8 months, GFR <58 ml/min per 1.73 m2; aged 8 months-1 year, GFR <65 ml/min per 1.73 m2; aged 1–1.5 years, GFR <74 ml/min per 1.73 m2; aged 1.5–2 years, GFR <76 ml/min per 1.73 m2; and age >2 years, GFR <90 ml/min per 1.73 m2.
Kidney medical history (on the basis of medical chart review): hypertension, treatment with antihypertensives, family history of kidney disease, CKD, dialysis, congenital kidney anomaly, kidney stones, vesicoureteral reflux, urinary tract infection, serum electrolyte abnormality requiring treatment or AKI.
Nephrotoxic drugs include acyclovir, amphotericin, aminoglycosides (gentamycin, tobramycin, amikacin), vancomycin, angiotensin-converting enzyme inhibitor, ganciclovir/valganciclovir, ifosfamide, or methotrexate.
Only infections with a positive culture and documentation were tabulated.
Kidney infection or urinary tract infection includes any infection with a specimen originating from the kidneys or urinary tract infection.
Nephrotoxic drugs include acyclovir, amphotericin, aminoglycosides (other than gentamycin, tobramycin and amikacin), vancomycin, angiotensin converting enzyme inhibitor, ganciclovir/valganciclovir, ifosfamide, or methotrexate.
Stands for significant difference between Outcome and No Outcome groups: P < 0.05.
Stands for significant difference between Outcome and No Outcome groups: P < 0.01.