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Kidney problems

Everyone can develop kidney problems, even people who have never had cancer. Some cancer treatments can increase this risk. It is important to recognize symptoms and signs that may point to kidney problems.

What are kidney problems?

The kidneys remove waste products from the body and help maintain the right balance of fluids and salts. They regulate blood pressure and produce hormones, including those needed to make enough red blood cells.

Sometimes kidney problems can develop:

  • Damage to the kidney filters, which can cause:

    • waste products to build up — often only noticeable after a long time

    • loss of important salts

    • high blood pressure, which increases the risk of heart and vascular disease

Do I have an increased risk of kidney problems?

Anyone, including people who have never had cancer, can develop kidney problems. However, some cancer treatments can increase the risk.

The following treatments can increase the risk of kidney problems:

  • Chemotherapy such as ifosfamide, cisplatin, and carboplatin

  • Any dose of radiation to the kidney(s) or urinary tract, or to an area where the kidneys or urinary tract are located

  • Allogeneic stem cell transplantation

  • Surgery in which a kidney is removed (nephrectomy)

You can check your treatment summary to see whether you received one or more of these treatments. If you do not have a summary, contact the LATER clinic or the hospital where you were treated. Kidney problems are not always caused by treatment—other causes include high blood pressure or diabetes.

What are signs and symptoms of kidney problems?

Certain signs and symptoms may indicate kidney problems. Even if you have no symptoms now, it is important to recognise them should they occur in the future.

Symptoms that may indicate kidney problems include:

  • High blood pressure

  • Swelling in the legs or elsewhere, such as around the eyes (especially in children)

  • Urinating more or less often than usual

  • Blood in the urine

  • Foamy urine

If you recognise any of these symptoms, contact your GP or LATER doctor.

I have an increased risk of kidney problems. What tests are needed and when?

If you have an increased risk of kidney problems, the recommendation is to have:

  • a blood test every 5 years to measure creatinine

  • a urine test every 5 years to measure protein and creatinine

If you were treated with ifosfamide, cisplatin, or carboplatin, additional tests are recommended:

Blood tests for:

  • Sodium

  • Potassium

  • Magnesium

  • Phosphate

  • Calcium

  • Albumin

Urine tests for:

  • Glucose

  • Phosphate

What happens if I have kidney problems?

If you have kidney problems, your GP or LATER doctor will likely refer you to a:

  • Nephrologist (a doctor specialised in kidney diseases)

The nephrologist will discuss treatment options with you.

What else can I do?

Living with (an increased risk of) kidney problems can be difficult. Talking with friends and family may help. Contact with others in a similar situation can also be helpful, for example through a patient organisation such as VOX, part of the Dutch Childhood Cancer Parent Organisation.

If you have only one kidney, it is important to protect it. Be careful with certain painkillers such as ibuprofen, diclofenac, naproxen, and paracetamol — these can damage the kidneys.

Take good care of yourself. You can reduce the risk of kidney problems by following a healthy lifestyle. Use as little salt as possible and drink enough fluids — especially in hot weather or during physical activity. Take care of your mental wellbeing as well; small changes can have a positive impact on your physical and mental health.

It is important to know that you have an increased risk of kidney problems and to recognise the signs and symptoms. If you have questions or concerns after reading this information, contact your GP or LATER doctor.

Where can I find more information?

On the LATER website you can also find information about:

  • Healthy lifestyle

  • Mental health

  • Urinary tract problems

The PanCare Plain Language Summaries contain links to reliable information in English.

You can search online for information about kidney problems, but keep in mind that it is not always accurate or up to date.

Disclaimer

This information is based on the plain-language summary of the guideline by the PanCare Plain Information Group and has been adapted where necessary to the Dutch LATER guideline. Do not rely solely on this information if you experience symptoms — always contact your GP, LATER doctor, or specialist.