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Table 2 Summary of eligible studies on kidney function, n = 2 studies

From: Late effects of high-dose methotrexate treatment in childhood cancer survivors—a systematic review

First author

Year

Country

Final cohort (male:female), diagnosis and cohort description

Age at diagnosis [years]

Follow-up [years]

Method

Effect of HD-MTX

Grönroos et al. 2008

Finland

28 (12:16); ALL, lymphoma

Median 7.7 (range 1.5–15.4)

Median 6.0 (range 1.0–10.0)

iGFR with 51CR-EDTA or 99mTc-DTPA, urinalysis continuous variables

8 g/m2/dose vs. 5 g/m2/dose

▪Albuminuria: no sign. association with its occurrence (OR 1.50, 95%CI 0.29–0.78)

▪Proteinuria: no sign. association with its occurrence (OR 4.67, 95%CI 0.42–52.12)

Study group:

▪Group I: HD-MTX (n = 28)

5 g/m2/dose: n = 16

8 g/m2/dose: n = 12

Follow-up: since end of treatment

Definition:

▪iGFR: reduced if iGFR

▪ < 115 ml/min/1.73m2

▪Urinary albuminuria: abnormal if albumin/creatinine ratio > 2.5 mg/mmol

8 g/m2/dose vs. 5 g/m2/dose

▪iGFR: no sign. association with reduced iGFR

Higher cumulative dose:

▪iGFR: no sign. association with reduced iGFR

▪Albuminuria: no sign. association with its occurrence

▪Proteinuria: no sign. association with its occurrence

Mulder et al. 2013

The Netherlands

1122 (599:523); different tumors

Median 7.6 (range 0.0–17.8)

Median 15.3 (5.0–36.1)

GFR (CKD-EPI formula for adults) continuous variables

Higher cumulative dose:

▪GFR: no sign. association with reduced GFR

Study group:

▪Group I: HD-MTX (n = 253)

Follow-up: since diagnosis

Definition:

▪GFR reduced if GFR < 90 ml/min/ 1.73m2

Exposure:

▪GFR over time: no sign. effect of HD-MTX on deterioration of GFR over time

  1. ALL acute lymphoblastic leukemia, CI confidence interval, CKD-EPI Chronic Kidney Disease Epidemiology Collaboration, GFR glomerular filtration rate, HD-MTX high-dose methotrexate, iGFR isotope glomerular filtration rate, n number, OR odds ratio, sign. significant(ly). Numbers taken from the original article even though OR is not within the 95%CI