Background:Hospitalisation rates can be used as an indirect indicator of the burden and severity of adverse health outcomes in childhood cancer survivors. We aimed to determine the long-term risks of hospitalisation related to renal and urinary diseases. Methods:The French Childhood Cancer Survivor Study cohort was linked with data from the French National Healthcare System database, which enabled the identification of hospitalisations related to renal or urinary diseases. Clinical and detailed treatment data were collected from medical records. Dose-volume histograms were estimated for patients treated with radiotherapy. Relative Risks (RRs) were estimated using Poisson regression. Results:A total of 5498 survivors were followed for 42118 person-years. Survivors experience 2.9 times more renal hospitalisations than expected in the general population. Exposing more than 10% of the kidneys’ volume to at least 20 Gray increases the risk of being hospitalised for renal causes by 2.2 (95%CI=1.3-3.6). Nephrectomised survivors treated with high doses of ifosfamide (>60g/m²) have an extremely high risk of hospitalisation for renal causes. In the case of hospitalisation for urinary causes, treatment by anthracycline administration was found to be associated with an almost 2-fold higher risk of hospitalisation compared to the general population. Conclusion:These results support the need for careful monitoring of long-term renal diseases in survivors who have undergone nephrectomy, those treated with high doses of radiation (≥20Gy) even to small volumes of the kidneys, and those with predisposing risk factors. Impact:This study provides new evidence with potential impact on surveillance guidelines related to dose-volume indicators associated with renal toxicity.

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