The influence of age on nephrotoxicity following chemotherapy in children.
The influence of age on nephrotoxicity following chemotherapy in children.
复制标题
年龄对儿童化疗后肾毒性的影响。
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
A. W. Craft
中科院分区：
文献类型：
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作者：
R. Skinner;Andrew D.J. Pearson;L. Price;M. G. Coulthard;A. W. Craft
肾毒性是儿童化疗的一个重要不良反应。用异环磷酰胺或顺铂治疗5岁或以下儿童（“年幼儿童”）与5岁以上儿童（“年长儿童”）的肾功能进行比较。化疗完成后对18名接受异环磷酰胺治疗的儿童（6名儿童，12名儿童）进行了研究，对28名接受顺铂治疗的患者（16名儿童，12名儿童）进行了评估。通过血浆51铬标记乙酸清除率测定肾小球滤过率。通过测定血浆和尿钙、磷酸盐、镁和葡萄糖浓度评估近端肾小管功能；计算他们的排泄分数和肾磷阈值；测定尿中β 2微球蛋白的排泄量。通过测量晨尿渗透压来评估远端肾小管功能。年幼的儿童比使用异环磷酰胺治疗的年龄较大的儿童有更严重的近端肾小管毒性，其血浆磷酸盐浓度显著降低，葡萄糖排泄分数较高。然而，没有证据表明异环磷酰胺治疗后肾小球或远端小管损伤有任何差异，也没有证据表明年龄较小和较大的顺铂治疗儿童在肾功能的任何方面有差异。儿童服用异环磷酰胺后近端肾小管毒性增加可能对未来的生长发育有严重影响。
Nephrotoxicity is an important adverse effect of chemotherapy in children. Renal function after treatment with either ifosfamide or cisplatinum in children aged 5 years or less ('younger children') was compared with that in those over 5 years ('older children'). Eighteen children (six younger, 12 older) given ifosfamide were studied after completion of chemotherapy, and 28 patients (16 younger, 12 older) were evaluated after cisplatinum. Glomerular filtration rate was measured from the plasma clearance of 51chromium-labelled edetic acid. Proximal tubular function was assessed by determination of plasma and urine calcium, phosphate, magnesium and glucose concentration; calculations of their fractional excretions, and of the renal threshold for phosphate; and measurement of urinary excretion of beta 2-microglobulin. Distal tubular function was evaluated by measurement of the early morning urine osmolality. Younger children had more severe proximal tubular toxicity than older children treated with ifosfamide, with significantly lower plasma phosphate concentrations and higher fractional excretions of glucose. However, there was no evidence of any such difference in glomerular or distal tubular damage after ifosfamide, and no difference in any aspect of renal function between younger and older children treated with cisplatinum. Increased proximal tubular toxicity after ifosfamide in younger children may have serious implications for future growth and development.