{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:51:03Z","timestamp":1791265863476,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Children treated with ifosfamide seem to have an increased risk for developing chronic kidney disease (CKD) already within the first years following chemotherapy. However, studies investigating CKD prevalence in this specific phase are scarce. This study aimed to determine the prevalence, course, and determinants of CKD in ifosfamide\u2010treated children within the first five years after chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cohort study included children treated with ifosfamide at the Princess M\u00e1xima Center for pediatric oncology in the Netherlands between 2015 and 2021. Chronic kidney disease was defined as decreased eGFR (&lt;\u200990\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ) and\/or proteinuria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      This cohort consisted of 292 patients, with a median follow\u2010up duration of 30\u2009months (IQR 7\u201346). The overall prevalence of CKD was 42.1% (123\/292 patients), with 29 being at substantial risk of progression to kidney failure (eGFR &lt;\u200960\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ). In 21 patients, CKD was reversible. A cause\u2010specific hazard model identified cumulative ifosfamide dose of 30\u201359.9\u2009g\/m\n                      <jats:sup>2<\/jats:sup>\n                      (HR\n                      <jats:sub>cs<\/jats:sub>\n                      1.95, 95% CI 1.22\u20133.12) or\u2009&gt;\u200960\u2009g\/m\n                      <jats:sup>2<\/jats:sup>\n                      (HR\n                      <jats:sub>cs<\/jats:sub>\n                      4.09, 95% CI 2.08\u20138.02), increasing age at diagnosis (HR\n                      <jats:sub>cs<\/jats:sub>\n                      1.12, 95% CI 1.06\u20131.18), and \u2265\u20092 episodes of acute kidney injury (AKI) during treatment (HR\n                      <jats:sub>cs<\/jats:sub>\n                      3.81, 95% CI 2.24\u20136.46) as significant determinants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>With a prevalence of 42.1% within the first five years following ifosfamide administration, CKD is a common early complication, with varying severity; seven patients developed severe CKD (G4\u2013G5). These findings highlight the importance of awareness and long\u2010term kidney function surveillance, especially in patients with a history of AKI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72231","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:39:40Z","timestamp":1788158380000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Kidney Disease in Children Within Five Years After Ifosfamide Chemotherapy for Childhood Cancer: A Dutch Pediatric Oncology Cohort Study"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6241-110X","authenticated-orcid":false,"given":"Lotte","family":"Pitlo","sequence":"first","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Department of Pediatric Nephrology Wilhelmina Children's Hospital\/University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1976-9962","authenticated-orcid":false,"given":"Francis S. P. L.","family":"Wens","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5227-2057","authenticated-orcid":false,"given":"Paulien A. M. A.","family":"Raymakers\u2010Janssen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Department of Pediatric Intensive Care Wilhelmina Children's Hospital\/University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8519-8906","authenticated-orcid":false,"given":"Lianne M.","family":"Haveman","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7659-1028","authenticated-orcid":false,"given":"Johannes H. M.","family":"Merks","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Division of Imaging and Oncology University Medical Center Utrecht, Utrecht University  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8849-8573","authenticated-orcid":false,"given":"Martine","family":"van Grotel","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0331-713X","authenticated-orcid":false,"given":"Geert O.","family":"Janssens","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Department of Radiation Oncology University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5588-0277","authenticated-orcid":false,"given":"Marta","family":"Fiocco","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Mathematical Institute Leiden University  Leiden the Netherlands"},{"name":"Biomedical Data Science Department, Section Medical Statistics Leiden University Medical Center  Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7760-879X","authenticated-orcid":false,"given":"Marry M.","family":"van den Heuvel\u2010Eibrink","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Division Child Health Wilhelmina Children's Hospital\/University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6396-6585","authenticated-orcid":false,"given":"Gerrit","family":"van den Berg","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology  Utrecht the Netherlands"},{"name":"Department of Pediatric Nephrology Wilhelmina Children's Hospital\/University Medical Center Utrecht  Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2020.101733"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2021.09.001"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa060185"},{"issue":"3","key":"e_1_2_14_5_1","article-title":"Early and Late Adverse Renal Effects After Potentially Nephrotoxic Treatment for Childhood Cancer","volume":"3","author":"Kooijmans E. 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