Kidney Late Effects

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Certain childhood cancer treatments can cause kidney problems later in life.

How kidneys function

The kidneys are 2 organs located below the rib cage near the middle of the back. They remove waste and extra liquid from blood. That process produces urine.

If kidneys don’t work correctly, fluid and waste products can build up in the blood. This can cause health problems.

Childhood cancer treatments that can cause kidney problems

Therapies that can cause kidney problems include radiation, certain medicines, and surgical procedures.

Medicines

Cisplatin
Carboplatin
Ifosfamide
Antibiotics such as tobramycin, gentamicin, and amphotericin
Medicines for graft-versus-host disease (a complication of hematopoietic cell transplant). These include cyclosporine and tacrolimus.

Radiation

Kidney area
Abdomen
Total body

Surgery

Removal of one or both kidneys (nephrectomy)
Removal of bladder (cystectomy)

Other risk factors

High blood pressure
Diabetes
History of urinary tract problems such as frequent urinary tract infections and reflux (backward flow of urine)
Cystectomy

Signs and symptoms of kidney problems

Swelling, especially of the feet and ankles (edema)
Low red blood cell count (anemia)
High blood pressure (hypertension)

People who have signs and symptoms of kidney problems may also have:

Fatigue
Nausea and vomiting
Drowsiness
Itchy skin
Headaches

What survivors can do

Know your risks and monitor health

Ask your oncologist about your risk of late effects.
Tell your primary health care provider about your risk. Share a copy of your Survivorship Care Plan, which includes details about your cancer treatment and information about health problems that may occur because of your treatment.
Have a yearly physical examination including a blood pressure check.
Have blood tests for kidney function (BUN and creatinine) and salt levels at the first long-term follow-up visit.
Patients who have had a bladder removal (cystectomy) should see an urologist once a year.

Prevention

Survivors at risk for developing kidney problems are encouraged to take steps to keep their kidneys healthy:

Drink plenty of water, especially during physical activity and spending time outdoors in the sun and heat.
Contact a health care provider immediately if you have symptoms of a urinary tract infection. Symptoms may include pain or burning while urinating, urinating more than usual, and feeling an urgent need to urinate.
Use non-steroidal anti-inflammatory drugs (NSAIDs) with caution. These medicines include aspirin, ibuprofen, acetaminophen, and naproxen. They can cause kidney damage. This is especially true when taken in large doses or when 2 or more of these medications are combined with caffeine or codeine over a long period.