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Early detection of kidney dysfunction

Pediatric oncologist Margreet Veening is researching late effects, fertility problems but also kidney damage, as part of the DCCSS LATER studies. 'When you detect kidney dysfunction at an early stage, you can often still intervene with medication, diet and lifestyle advice and prevent further deterioration.'
She published with several colleagues several articles last year on renal late effects and hypertension and kidney dysfunction Margreet Veening, a pediatric oncologist and late effects researcher at the Máxima Center since 2018, is working with a KWF grant on research into kidney dysfunction in adult pediatric cancer survivors who received treatment that potentially harms the kidney. Margreet says: ‘When it comes to side effects, at the time of treatment but also in later life, the so-called late effects, there is still a lot of work to be done and a lot of profit to be made.’

Chronic kidney failure

Impaired kidney function often comes to light late because it usually does not cause any symptoms. Margreet explains: ‘Our research showed that survivors of childhood cancer have a worse kidney function compared to the general population. The treatments, such as removal of a kidney, radiation on the kidney and some chemotherapy, increase the risk of chronic kidney failure. These survivors can now be targeted and treated as needed and prevent further deterioration of kidney function. We also showed that adults treated in the past with total body radiation (as part of a bone marrow transplant), radiation on a kidney and certain chemotherapy have an increased risk of protein leakage in the kidney, which contributed to accelerated decline in kidney function. This can be reduced with medication, which keeps kidney function good for longer.’

High blood pressure

Relatively many survivors appear to have a higher risk of hypertension (high blood pressure). 'We saw this in adults who in the past had received radiation on a kidney or total body radiation,' Margreet says. 'This is something we can now pay close attention to and treat early in these adults, but also in children who need such treatment in the future. We do this by giving advice on lifestyle, such as preventing obesity, sufficient exercising, not smoking and treatment with medication. This is important because high blood pressure increases the risk of cardiovascular disease.’


Margreet investigated multiple renal (kidney) late effects in her research and advocates preventive intervention, because it is only when the kidneys virtually stop working that symptoms arise. Margreet: 'With the results of the research funded by KWF, we can better inform current survivors, but also children with cancer in the future, about the risks of late kidney dysfunction. At the Máxima Center, all children who were diagnosed with cancer five years earlier are followed up at the LATER outpatient clinic. By knowing who has an increased risk of kidney dysfunction, we can improve the current guidelines for follow-up and thereby contribute to our ultimate goal: to cure as many children as possible without undesirable late effects.’