Acute Kidney Injury
Acute Kidney Injury in paediatric cancer patients
Background
Over the last few decades, cancer therapy has been improved by the introduction of intensified treatment protocols and advanced supportive therapy. As a consequence, outcomes for children diagnosed with cancer have progressed from an estimated 80% mortality in the late 80’s to an 80% survival at this time. However, these developments have also increased morbidity, including the incidence of disease- or treatment-associated complications, many of which require intensive care treatment. Renal failure is one of these serious complications.
Relevance for cancer research
Studies on outcome assessment in paediatric cancer and hematopoietic stem cell transplant (HSCT) patients are scarce. Acute kidney injury (AKI) is common in the post-HSCT phase and contributes to morbidity in these critically ill children. Continuous renal replacement therapy (CRRT) has become the most widely used renal support modality for use in the AKI population. A better understanding of the impact of CRRT on short- and long-term outcomes is hence essential for an optimal CRRT implementation. Furthermore, early detection of AKI is critical. The diagnosis of AKI is currently based on an increase in serum creatine (SCr), which is a marker of glomerular filtration rate (GFR) and the presence of oliguria. Our recently study showed Serum creatinine and oliguria seem to be not sensitive markers for timely detection of AKI in this population.
Aims
Aims
Within this project we will investigate:
the impact of CRRT on both short and long-term outcomes among these children and factors that influence these outcomes;
the applicability of non-invasive biomarkers, including extracellular vesicles to identify early AKI in paediatric cancer patients.
Project Outcomes
Project Outcomes
Raymakers-Janssen PAMA, Lilien M, Tibboel D, Kneyber MCJ, Dijkstra S, van Woensel, JBM, Lemson J, Cransberg K, van den Heuvel-Eibrink MM & Wösten-van Asperen RM (2019). Epidemiology and Outcome of Critically Ill Pediatric Cancer and Hematopoietic Stem Cell Transplant Patients Requiring Continuous Renal Replacement Therapy: A Retrospective Nationwide Cohort Study. Crit Care Med, 47(11):e893-e901. doi: 10.1097/CCM.0000000000003973
Raymakers-Janssen PAMA, Lilien M, van Kessel IA, Veldhoen ES, Wösten-van Asperen RM & van Gestel JPJ (2017). Citrate versus heparin anticoagulation in continuous renal replacement therapy in small children. Pediatr Nephrol 32:1971–78. doi: 10.1007/s00467-017-3694-4
Team
Team
Prof.dr. M. Fiocco, Mathematical Institute Leiden University, Department of Biomedical Data Sciences Leiden University Medical Center & Princess Máxima Center for Pediatric Oncology
Dr. M. Lilien, University Medical Center (UMC) Utrecht
P. Raymakers-Janssen, MSc, Princess Máxima Center for Pediatric Oncology & Wilhelmina Children’s Hospital
Prof. dr. M.M. van den Heuvel-Eibrink, Princess Máxima Center for Pediatric Oncology
Dr. R.M. Wösten-van Asperen, University Medical Center (UMC) Utrecht