How Does Wilms Tumor Affect The Kidney?

Wilms Tumor, also known as nephroblastoma, is malignant cancer in the cells of the kidney(s). It is most common in infants and young children below the age of four. However, that doesn’t mean children above the age of five or older, or even adults cannot have the condition, but it is very rare. Nephroblastoma accounts for about 6% of all childhood cancers, and although one kidney is usually affected in most cases, approximately 5-10% of the children with cancer have both kidneys affected. Wilms tumor has greater survivorship than other types of cancers because most children are usually cured of the condition. Different children will have different prognosis and survivorship, so the outcome may not be the same for all kids with Wilms tumor.[1]

How Does Wilms Tumor Affect The Kidney?

How Does Wilms Tumor Affect The Kidney?

Like any other type of cancer, Wilms tumor will one way or the other affect the kidney(s) involved. It is important to first establish that adult kidney cancer is not related to Wilms tumor. That is to simply mean that they are both totally different conditions, and Wilms tumor doesn’t result in kidney cancer at any cost. Moving on, some children who’ve been treated for Wilms tumor may develop complications in their later life. The kidneys are important organs in the body. They perform several tasks including filtering the blood to remove excess water, salt, and waste products, as well as control blood pressure and ensure the body has enough red blood cells.

As a way of curing cancer, the treatment plan may include surgery, where part of or all the kidney is removed, as well as any other structures involved. This means that the child will have to live without one kidney. On top of that, chemotherapy, nephrectomy, and radiation treatments may lead to side effects, and in the worst case scenario, cancer may reoccur, or a second malignancy may develop. The treatment plan of Wilms tumor has a 90% success rate, and it is expected that the treatment plans may affect the functionality of the affected kidney in the long-term.

Some of the ways the involved kidney(s) is affected includes; severe reduction in glomerular filtration rate, chronic kidney disease after removal of the kidney, and end-stage renal disease, which is rare. Additionally, kids who develop chronic kidney disease are likely to develop cardiovascular disease and at worst face death. Constant check-ups after survivorship of Wilms tumor is necessary so as to monitor not only the functionality of the remaining kidney but also glomerular filtration rate, the excretion of albumin urine, as well as urine sediment analysis to detect any arising abnormalities. All Wilms tumor survivors are at a greater risk of acute kidney injury, and any deficiencies in the renal function may result in hypertension.[1] [4]

Understanding Wilms Tumor

Wilms tumor is often unilateral, meaning only one kidney is affected. Nevertheless, about 5-10% of children with Wilms tumor have bilateral disease, where both kidneys are affected at the same time. In terms of size, the cancerous mass can become quite large, and that can happen even before the condition has been diagnosed. As a matter of fact, the mass at the time of discovery is usually many times larger than the kidney. Despite growing very large, in most cases, the tumor has not metastasized to other organs, which makes it easier to cure cancer.

Wilms tumor is considered to occur sporadically, i.e. by chance. But it is associated with genetic mutations that interfere with cell growth in the kidneys. The complications of the genetic mutations usually arise after birth, but it can be that the child was born with a genetic alteration, which increases their likelihood of developing cancer. These genetic alterations can involve syndromes such as Denys-Drash syndrome, Beckwith-Wiedemann syndrome, and WAGR syndrome.[2] [3]

Conclusion

Wilms tumor can affect the kidney in ways associated with the functionality and development of other conditions that are life-long. The incidences and causes of renal dysfunction will vary depending on the clinical representation of the tumor. Although a kidney is removed, the child can carry on with life as normally as possible since one kidney can perform in place of the other. However, it is important for regular checkups to keep track of the child’s progress, kidney functionality, and any arising complications.

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