Consensus-based recommendation for surveillance of renal problems a

This page is part of the PanCare follow-up recommendations for surveillance of late effects. Click here, for more information on these recommendations.

Who is at risk for renal problems?

CAYA cancer survivors treated with

  • ifosfamide
  • cisplatin
  • carboplatin
  • radiotherapy to volume exposing the kidney or urinary tract, including TBI
  • nephrectomy
  • HSCT

What renal problems might occur?

  • Glomerular dysfunction
  • Tubular dysfunction

What surveillance modality should be used and at what frequency should it be performed?

All survivors at risk:

  • Glomerular function testing consisting of:
    • blood testing: creatinine
    • urine testing: creatinine, proteinuria
    • calculation of eGFR

at least every 5 years, starting at entry into long-term follow-up.

CAYA cancer survivors treated with ifosfamide, cisplatin or carboplatin:

  • Tubular function testing consisting of:
    • blood testing: sodium, potassium, magnesium, phosphate, calcium, albumin
    • urine testing: glucose, phosphate

at least every 5 years, starting at entry into long-term follow-up

What other advice should be given with a nephrectomy?

  • Education about caution in the use of NSAIDs

  • Counselling about single kidney-related health risks
    at entry into long-term follow-up and periodically

What should be done if abnormalities are identified?

  • Electrolyte supplementation as guided by serum biochemistry if an electrolyte imbalance is detected

  • Refer to a nephrologist if proteinuria and/or chronic kidney disease are identified


While PanCare strives to provide accurate and complete information that is up-to-date as of the date of publication, we acknowledge that the sequence of referral and diagnostic tests might vary according to the local and national healthcare system logistics.

It is recognised that survivors and their healthcare professionals have the final responsibility for making decisions concerning their long-term follow-up care. As such, they may choose to either adopt these recommendations or not to do so after individual informed discussion. It is good practice to document this decision.

In addition to regular surveillance, real-time awareness and prompt reporting of new symptoms and signs is essential to the early detection and timely treatment of late effects.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information.

The PanCare materials are free to use for anyone aiming to inform about late effects and long-term survivorship care. However, no financial advantage may be achieved. All communication should reference PanCare and link to the PanCare website.