Kooijmans, E.C.M.; Pal, H.J.H. van der; Pluijm, S.M.F.; Bresters, D.; Dulmen-den Broeder, E. van; Heiden-van der Loo, M. van der; ... ; Dutch LATER Study Grp 2022
Purpose: To evaluate the prevalence of and risk factors for hypertension in child-hood cancer survivors (CCSs) who were treated with potentially nephrotoxic therapies. Methods: In the Dutch... Show morePurpose: To evaluate the prevalence of and risk factors for hypertension in child-hood cancer survivors (CCSs) who were treated with potentially nephrotoxic therapies. Methods: In the Dutch Childhood Cancer Survivor Study LATER cohort part 2 renal study, 1024 CCS >= 5 years after diagnosis, aged >= 18 years at study participation, treated between 1963 and 2001 with nephrectomy, abdominal radiotherapy, total body irradiation (TBI), cisplatin, carboplatin, ifosfamide, high-dose cyclophosphamide (>= 1 g/m(2) per single dose or >= 10 g/m(2) 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: Median age at cancer diagnosis was 4.7 years (interquartile range, IQR 2.4-9.2), at study 32.5 years (IQR 27.7-38.0) and follow-up 25.5 years (IQR 21.4-30.3). The prevalence of hypertension was comparable in CCS (16.3%) and controls (18.2%). In 12% of CCS and 17.8% of controls, hypertension was undiagnosed. A decreased GFR (< 60 ml/min/1.73 m(2)) 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 Z 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. (C) 2022 The Author(s). Published by Elsevier Ltd. Show less
