RENAL PROBLEMS

Kidney (renal) problems

The kidneys are a pair of organs located on each side of the spine. The kidneys make urine by filtering excess water and waste from the blood. The urine is then stored in the bladder until you pass it. For more information on lower urinary tract problems, please read: Lower urinary tract problems.

Sometimes problems can occur with the kidneys. Kidney (renal) problems include:

  • Glomerular dysfunction, where the tiny filters in the kidneys become damaged. When this happens, blood cells and proteins that should remain in the bloodstream, pass through the filters and end up in the urine.
  • Tubular dysfunction, where the parts of the kidney that reabsorb water and some important substances (such as potassium, phosphate, magnesium, glucose) become damaged. When this happens, the kidney can no longer reabsorb enough water (and substances such as potassium) after it is filtered.

Am I at higher risk of kidney problems?

Anyone, including people who have never had cancer treatment, may develop kidney problems. However, there are some cancer treatments that may increase the risk of having kidney problems later in life. The problems that can occur depend on the type of cancer treatment received.

The following treatments can increase the risk of kidney problems:

  • Chemotherapy drugs, for example ifosfamide, cisplatin, and carboplatin
  • Any dose of radiotherapy to the kidney(s) or urinary tract, or an area that includes the kidney(s) and urinary tract
  • Stem cell transplantation
  • Surgery that involves removal of a kidney

You can find out if you have received any of these treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you experience kidney problems, it does not always mean that this is caused by your cancer treatment. Kidney problems may have other causes such as high blood pressure or diabetes. For more information on high blood pressure and diabetes please read: … .

What are the symptoms and signs of kidney problems?

There are symptoms and signs that can tell you if you might have kidney problems. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

In early stages, kidney problems usually do not lead to any symptoms. These symptoms and signs may suggest that you have kidney problems:

  • High blood pressure (hypertension) symptoms and signs. For more information on hypertension, please read: Hypertension.
  • Swelling of the legs or other parts of the body (eg. around the eyes especially in children)
  • Passing urine more or less frequently than usual
  • Blood in the urine
  • Frothy or foaming urine

If you recognise any of these symptoms or signs in yourself, please contact a general practitioner or follow-up care specialist.

I am at higher risk of kidney problems. What tests should I have and when?

If you are at higher risk of kidney problems, it is advised to:

  • have a blood test (to measure creatinine) at least every 5 years.
  • have a urine test (to measure protein and creatinine) at least every 5 years.

In addition, if you received the chemotherapy drugs ifosfamide, cisplatin or carboplatin, it is advised to also have the following substances measured in the blood and urine at least every 5 years:

In the blood In the urine
  • Sodium
  • Potassium
  • Magnesium
  • Phosphate
  • Calcium
  • Albumin
  • Glucose
  • Phosphate

What happens if I have kidney problems?

If you have kidney problems, your general practitioner or follow-up care specialist will probably refer you to a:

  • Nephrologist (physician specialised in the kidneys)

The nephrologist may discuss different treatment options with you.

What else can I do?

Knowing that you may be at increased risk of kidney problems can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

If you are currently living with one kidney, it is important to protect your kidney from injury. Be careful about taking medication such as ibuprofen and aspirin as these may damage the kidney.

If you are at risk of kidney problems or if you experience kidney problems, adopting or maintaining a healthy lifestyle is extremely important. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

It is important that you are aware of the possibility of developing kidney problems and that you know the symptoms and signs. If you have any further questions or if the information in this brochure concerns you, please contact your general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about kidney problems online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

  • National Kidney Foundation: Here you can find more information about contact sports for children with kidney disease
  • Kidney Care UK: Here you can find more information about kidney problems in general and about support for those affected by it in the UK

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Renal problems” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext