Fasting Intervention for Children With Unilateral Renal Tumors to Reduce Toxicity

Christiaan A.J. Oudmaijer; Winnie M.C.van den Boogaard; Daphne S.J. Komninos; Emma J. Verwaaijen; Hanneke M.van Santen; Marc R. Lilien; Jan H.J. Hoeijmakers; Marc H.W. Wijnen; Marry M.van den Heuvel-Eibrink; Wilbert P. Vermeij

doi:10.3389/fped.2022.828615

Fasting Intervention for Children With Unilateral Renal Tumors to Reduce Toxicity

Christiaan A.J. Oudmaijer^*, Winnie M.C.van den Boogaard, Daphne S.J. Komninos, Emma J. Verwaaijen, Hanneke M.van Santen, Marc R. Lilien, Jan H.J. Hoeijmakers, Marc H.W. Wijnen, Marry M.van den Heuvel-Eibrink, Wilbert P. Vermeij

^*Corresponding author for this work

Molecular Genetics

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Abstract

Childhood renal tumors account for around 6% of all childhood cancers and 90% of these cases are Wilms tumor. In Europe, the SIOP-RTSG approach is considered standard of care and has resulted in five-year survival rates of over 90%. Efforts to decrease toxicity are now being pursued. Short-term fasting (STF), a short but strong reduction in calorie-intake, is associated with improved fitness, enhanced coping with acute physical stress and a lower risk of age-associated diseases. STF temporarily reduces growth to boost resilience, maintenance, and defense-mechanisms, by which toxic side-effects of (oxidative) damage and inflammation are largely prevented. Renal surgery for Wilms tumor carries a risk of acute kidney injury (AKI) and pediatric patients that had an episode of AKI are at increased risk for developing chronic renal disease. STF could mitigate surgery-induced stress and could further improve outcomes. We aim to investigate the effect of STF on renal function recovery after renal tumor surgery by conducting a single-center, prospective, randomized, non-blinded, intervention study. Children diagnosed with a unilateral renal tumor and opting for curative treatment are eligible for inclusion. The main study objective is to investigate the potential decrease in occurrence of AKI due to STF. Secondary objectives include renal function recovery, child's wellbeing, physical functioning, and feasibility of and adherence to STF in children with cancer.

Original language	English
Article number	828615
Journal	Frontiers in Pediatrics
Volume	10
DOIs	https://doi.org/10.3389/fped.2022.828615
Publication status	Published - 27 Jan 2022

Bibliographical note

Funding Information:
The design and implementation of this study was conducted without support of a specific grant from any funding agency in the public, commercial or non-profit sectors. Research and writing of this manuscript were indirectly supported by ONCODE (Dutch Cancer Society). JH was additionally supported by the European Research Council Advanced Grant Dam2Age, NIH grant (PO1 AG017242), the Deutsche Forschungsgemeinschaft - Project-ID 73111208 - SFB 829, WV by the ADPS Longevity Research Award and Regiodeal Foodvalley, and JH and WV by BBoL (NWO-ENW), ZonMW Memorabel (733050810), and EJP-RD TC-NER RD20-113.

Publisher Copyright: Copyright © 2022 Oudmaijer, Boogaard, Komninos, Verwaaijen, Santen, Lilien, Hoeijmakers, Wijnen, Heuvel-Eibrink and Vermeij.

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Fasting Intervention for Children With Unilateral Renal Tumors to Reduce ToxicityFinal published version, 249 KBLicence: CC BY

Cite this

Oudmaijer, C. A. J., Boogaard, W. M. C. V. D., Komninos, D. S. J., Verwaaijen, E. J., Santen, H. M. V., Lilien, M. R., Hoeijmakers, J. H. J., Wijnen, M. H. W., Heuvel-Eibrink, M. M. V. D., & Vermeij, W. P. (2022). Fasting Intervention for Children With Unilateral Renal Tumors to Reduce Toxicity. Frontiers in Pediatrics, 10, Article 828615. https://doi.org/10.3389/fped.2022.828615

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title = "Fasting Intervention for Children With Unilateral Renal Tumors to Reduce Toxicity",

abstract = "Childhood renal tumors account for around 6% of all childhood cancers and 90% of these cases are Wilms tumor. In Europe, the SIOP-RTSG approach is considered standard of care and has resulted in five-year survival rates of over 90%. Efforts to decrease toxicity are now being pursued. Short-term fasting (STF), a short but strong reduction in calorie-intake, is associated with improved fitness, enhanced coping with acute physical stress and a lower risk of age-associated diseases. STF temporarily reduces growth to boost resilience, maintenance, and defense-mechanisms, by which toxic side-effects of (oxidative) damage and inflammation are largely prevented. Renal surgery for Wilms tumor carries a risk of acute kidney injury (AKI) and pediatric patients that had an episode of AKI are at increased risk for developing chronic renal disease. STF could mitigate surgery-induced stress and could further improve outcomes. We aim to investigate the effect of STF on renal function recovery after renal tumor surgery by conducting a single-center, prospective, randomized, non-blinded, intervention study. Children diagnosed with a unilateral renal tumor and opting for curative treatment are eligible for inclusion. The main study objective is to investigate the potential decrease in occurrence of AKI due to STF. Secondary objectives include renal function recovery, child's wellbeing, physical functioning, and feasibility of and adherence to STF in children with cancer.",

author = "Oudmaijer, {Christiaan A.J.} and Boogaard, {Winnie M.C.van den} and Komninos, {Daphne S.J.} and Verwaaijen, {Emma J.} and Santen, {Hanneke M.van} and Lilien, {Marc R.} and Hoeijmakers, {Jan H.J.} and Wijnen, {Marc H.W.} and Heuvel-Eibrink, {Marry M.van den} and Vermeij, {Wilbert P.}",

note = "Funding Information: The design and implementation of this study was conducted without support of a specific grant from any funding agency in the public, commercial or non-profit sectors. Research and writing of this manuscript were indirectly supported by ONCODE (Dutch Cancer Society). JH was additionally supported by the European Research Council Advanced Grant Dam2Age, NIH grant (PO1 AG017242), the Deutsche Forschungsgemeinschaft - Project-ID 73111208 - SFB 829, WV by the ADPS Longevity Research Award and Regiodeal Foodvalley, and JH and WV by BBoL (NWO-ENW), ZonMW Memorabel (733050810), and EJP-RD TC-NER RD20-113. Publisher Copyright: Copyright {\textcopyright} 2022 Oudmaijer, Boogaard, Komninos, Verwaaijen, Santen, Lilien, Hoeijmakers, Wijnen, Heuvel-Eibrink and Vermeij.",

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AU - Verwaaijen, Emma J.

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AU - Vermeij, Wilbert P.

N1 - Funding Information: The design and implementation of this study was conducted without support of a specific grant from any funding agency in the public, commercial or non-profit sectors. Research and writing of this manuscript were indirectly supported by ONCODE (Dutch Cancer Society). JH was additionally supported by the European Research Council Advanced Grant Dam2Age, NIH grant (PO1 AG017242), the Deutsche Forschungsgemeinschaft - Project-ID 73111208 - SFB 829, WV by the ADPS Longevity Research Award and Regiodeal Foodvalley, and JH and WV by BBoL (NWO-ENW), ZonMW Memorabel (733050810), and EJP-RD TC-NER RD20-113. Publisher Copyright: Copyright © 2022 Oudmaijer, Boogaard, Komninos, Verwaaijen, Santen, Lilien, Hoeijmakers, Wijnen, Heuvel-Eibrink and Vermeij.

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AB - Childhood renal tumors account for around 6% of all childhood cancers and 90% of these cases are Wilms tumor. In Europe, the SIOP-RTSG approach is considered standard of care and has resulted in five-year survival rates of over 90%. Efforts to decrease toxicity are now being pursued. Short-term fasting (STF), a short but strong reduction in calorie-intake, is associated with improved fitness, enhanced coping with acute physical stress and a lower risk of age-associated diseases. STF temporarily reduces growth to boost resilience, maintenance, and defense-mechanisms, by which toxic side-effects of (oxidative) damage and inflammation are largely prevented. Renal surgery for Wilms tumor carries a risk of acute kidney injury (AKI) and pediatric patients that had an episode of AKI are at increased risk for developing chronic renal disease. STF could mitigate surgery-induced stress and could further improve outcomes. We aim to investigate the effect of STF on renal function recovery after renal tumor surgery by conducting a single-center, prospective, randomized, non-blinded, intervention study. Children diagnosed with a unilateral renal tumor and opting for curative treatment are eligible for inclusion. The main study objective is to investigate the potential decrease in occurrence of AKI due to STF. Secondary objectives include renal function recovery, child's wellbeing, physical functioning, and feasibility of and adherence to STF in children with cancer.

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Fasting Intervention for Children With Unilateral Renal Tumors to Reduce Toxicity

Abstract

Bibliographical note

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