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Late Effects

Late effects are complications that may arise with your child's health after cancer treatment due to the type of treatment used to combat the cancer. Except for stage IV renal cell carcinoma, treatment consists of surgery to remove the tumor. Special precautions and follow-up care is recommended for patients with only one kidney. For this reason, your son or daughter should have routine follow-up care and testing so problems can be caught earlier rather than later.

Symptoms of Kidney Damage:

• Low numbers of red blood cells in the blood (anemia)
• Protein in the urine
• Swollen ankles and feet
• High blood pressure

Recommended yearly testing throughout long-term follow-up:

If any previous kidney and/or liver abnormalities are detected, these should be monitored regularly and evaluated by a nephrologist (kidney doctor).

Long-term Preventative Care for children with one kidney:

Painkillers

Pain killers can cause kidney damage (talk with your child's doctor about alternatives). Limit your child's use of:

• Aspirin
• Acetaminophen
• Naproxen sodium
• Ibuprofen

Always remember to inform your doctor that your child has only one kidney.
 

Accidents

Accidents are the most frequent cause of kidney damage.

Avoid contact sports that could damage the kidney. Kidney guards can be purchased to protect the kidney when sports are played (consult your child's doctor before allowing participation in sport activities). Examples of commercially available kidney guards include: TKO kidney protector and WIS Wikmax kidney protector shirts.

American Academy of Pediatrics Recommendations

• Contact sports with a potential for injury: wrestling, basketball, football, rugby, and martial arts
• Before participating in any type of contact sport (from limited contact to collision sports), consult a pediatrician for an assessment
• Participating in boxing is not recommended
• Hockey: limited body checking is advised in ages 15 and under

National Pediatric Trauma Registry (1996-2001)

• 813 injuries to the kidney (85 of these were due to sports)
• Football causes the most sports related injuries to the kidney
• Sledding, snowboarding, skiing, and skateboarding were the next most common kidney injury due to sports

Always insist on your child wearing a seatbelt when riding or driving in a car. Car accidents are the most common cause of kidney damage.

When your child rides a bike, stress that he or she should avoid dangerous stunts and reckless riding since handlebars can easily damage the kidney if your child is thrown from the bike. Bicycle accidents are a more common cause of kidney injury than sports related accidents.

Drink Plenty of Fluids

Have your child drink lots of water. If he or she will be outside when it is hot or will be participating in any sports, make sure your child brings along and drinks extra amounts of water.

Urinary tract infection

Contact your child's doctor if your child has the following symptoms:

• Frequent urination with a burning sensation
• Pressing need to urinate with little urine produced