Cancer and its treatment may lead to kidney injury and the need for kidney replacement therapy (KRT). We identified 287 pediatric KRT patients with a history of malignancy from the European Society for Paediatric Nephrology/European Renal Association Registry. Of these, 197 had cancer as a primary cause of KRT (group 1) and 90 had a malignancy diagnosis before KRT (group 2). Two matched controls without malignancy were randomly selected for each patient. Data were complemented with a questionnaire. Median time to kidney transplantation (KT) from KRT initiation was 2.4 (IQR: 1.5-4.7), 1.5 (IQR: 0.4-3.3), 3.6 (IQR: 1.3 to Q3 not reached), and 1.1 (IQR: 0.3-3.6) years for group 1, their controls, group 2, and their controls, respectively. Overall 10-year mortality for those on KRT was higher among cancer patients vs controls in group 1: 16% vs 9% (adjusted hazard ratio 2.02, 95% CI: 1.21-3.37) and in group 2: 23% vs 14% (adjusted hazard ratio 2.32, 95% CI: 1.11-4.85). In contrast, 10-year patient survival after the first KT was comparable to controls (93% vs 96%; 100% vs 94%, in groups 1 and 2, respectively). In summary, childhood cancer survivors' KT was delayed, and their overall mortality when on KRT was increased, but once transplanted, their long-term outcome was similar to other KT recipients.

Department of Cardiology Endocrinology and Nephrology Holbaek Hospital Holbaek Denmark

Department of Paediatric Nephrology University Hospitals Bristol and Weston NHS Foundation Trust Bristol United Kingdom

Department of Pediatric Hematology and Oncology Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland

Department of Pediatric Nephrology and Transplantation Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland

Department of Pediatric Nephrology and Transplantation Children's Hospital Helsinki University Hospital and University of Helsinki Helsinki Finland; Department of Pediatrics Tampere University Hospital Tampere Finland

Department of Pediatric Nephrology Hôpital Robert Debré Assistance Publique Hôpitaux de Paris France

Department of Pediatric Nephrology İstanbul Pendik Education and Research Hospital Marmara University İstanbul Türkiye

Department of Pediatric Nephrology Medical University of Lublin Lublin Poland

Department of Pediatric Nephrology SI O O Shalimov National Scientific Center of Surgery and Transplantology of the National Academy of Medical Science of Ukraine Kyiv Ukraine

Department of Pediatric Nephrology University Hospitals Leuven Leuven Belgium

Department of Pediatrics 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic

Department of Pediatrics Bordeaux University Hospital Bordeaux Population Health Research Center UMR 1219 University of Bordeaux Bordeaux France

Department of Pediatrics Faculty of Medical Sciences in Zabrze Medical University of Silesia in Katowice Katowice Poland

Department of Pediatrics Medical University Graz Graz Austria

Division of Nephrology Department of Pediatrics Faculty of Medicine University of Debrecen Debrecen Hungary

Division of Paediatric and Adolescent Medicine Oslo University Hospital Oslo Norway

ESPN ERA Registry Department of Medical Informatics Amsterdam UMC University of Amsterdam Amsterdam Public Health Research Institute Amsterdam The Netherlands

Gazi University Faculty of Medicine Division of Pediatrics Department of Pediatric Nephrology Ankara Türkiye

Heidelberg University Medical Faculty Department of Pediatrics 1 University Children's Hospital Heidelberg Heidelberg Germany

Kings College London London United Kingdom; Department of Paediatric Nephrology Evelina London Children's Hospital London United Kingdom

Nephrology Department Meyer Children's Hospital University of Florence Florence Italy

Paediatric Nephrology Department Hospital La Paz Madrid Spain

Pediatric Nephrology Division Pediatric Department Unidade Local de Santo António Porto Portugal

Pediatric Nephrology Unit University Hospital of Padova Padova Italy; Department of Medicine University of Udine Udine Italy

Pirogov Russian National Research Medical University Moscow Russia

Swiss Childhood Cancer Registry Institute of Social and Preventive Medicine University of Bern Bern Switzerland; Pediatric Hematology and Oncology University Children's Hospital Bern University of Bern Bern Switzerland

University of Bristol Medical School Bristol United Kingdom

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