Chronic kidney disease consecutive to chemotherapy for chondroblastic osteosarcoma: A report on 6 pediatric cases

Nephrol Ther. 2021 Dec;17(7):543-546. doi: 10.1016/j.nephro.2021.05.004. Epub 2021 Jul 3.

Abstract

Background: The management of osteosarcoma in children and adolescents is based on poly-chemotherapy including several nephrotoxic drugs (e.g. ifosfamide, methotrexate, and cisplatinum). Chronic renal toxicity is a frequent complication but stage 5 chronic kidney disease requiring dialysis is rare. We report here a series of six pediatric patients with osteosarcoma displaying chronic kidney disease after chemotherapy.

Case-diagnosis/treatment: We retrospectively reviewed the medical charts, mainly for clinical history, timing between chemotherapy and development of tubulopathy and CKD, type of therapies and global evolution (chronic dialysis and further renal transplantation, n=2; death, n=1). Notably, all patients suffered from chondroblastic osteosarcoma.

Conclusions: Advanced chronic kidney disease can be a complication of osteosarcoma management that could more frequently lead to dialysis and further transplantation. It would be interesting to identify specific risk factors of such renal toxicity. The chondroblastic sub-type may be associated with such susceptibility, but this needs to be confirmed.

Keywords: Chondroblastic osteosarcoma; Chronic kidney disease; Glomerular toxicity; Ifosfamide; Nephrotoxicity; Pediatric tumor.

MeSH terms

  • Adolescent
  • Bone Neoplasms* / drug therapy
  • Child
  • Humans
  • Ifosfamide / adverse effects
  • Osteosarcoma* / drug therapy
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / therapy
  • Retrospective Studies

Substances

  • Ifosfamide