Claudio La Scola1, Anita Ammenti2, Giuseppe Puccio3, Maria Vittoria Lega1, Chiara De Mutiis1, Claudia Guiducci1, Laura De Petris4, Rosa Perretta5, Vittorio Venturoli6, Gianluca Vergine7, Andrea Zucchini8, Giovanni Montini9. 1. Nephrology and Dialysis Unit, Department of Pediatrics, Azienda Ospedaliero Universitaria Sant'Orsola-Malpighi, Bologna, Italy. 2. Department of Pediatrics, University of Parma, Parma, Italy. 3. Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy. 4. Pediatric Unit, Ospedale Mazzoni, Ascoli Piceno, Italy. 5. Pediatric Unit, Ospedale S. Bortolo, Vicenza, Italy. 6. Pediatric Unit, Ospedale Morgagni-Pierantoni, Forlì, Italy. 7. Pediatric Unit, Ospedale degli Infermi, Rimini, Italy. 8. Pediatric Unit, Ospedale di Faenza, Ravenna, Italy. 9. Pediatric Nephrology and Dialysis Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: giovanni.montini@unimi.it.
Abstract
PURPOSE: We assessed renal function outcome in children with congenital solitary kidney and evaluated prognostic risk factors. MATERIALS AND METHODS: We retrospectively studied the clinical charts of 210 children presenting with congenital solitary kidney at 2 pediatric nephrology and 5 pediatric units between January 2009 and October 2012. Children 0 to 18 years old with a congenital solitary kidney confirmed by scintigraphy were enrolled. Of the patients 146 were suitable for analysis. Median followup was 4.6 years. Primary outcome was decreased estimated glomerular filtration rate, and secondary outcome was occurrence of proteinuria and/or systemic hypertension. Primary outcome-free survival analysis was performed, including multiple regression analysis of significant risk factors. RESULTS: Decreased estimated glomerular filtration rate was present in 12% of children at a median age of 2.2 years. Primary outcome-free survival analysis revealed an estimated event-free survival of 82% (95% CI 74% to 91%) at 10 years. Estimated survival rate was significantly decreased in children with additional congenital anomalies of the kidney/urinary tract (54% vs 88% overall) or insufficient renal length vs expected for normal congenital solitary kidney. The latter was the strongest predictor of decreased estimated outcome-free survival (49% vs 89%, p <0.001). Occurrence of proteinuria and/or systemic hypertension was present in less than 5% of children. CONCLUSIONS: Some children with congenital solitary kidney show decreased glomerular filtration rate. Associated anomalies of the kidney/urinary tract and insufficient renal length appear to be significant risk factors. Adequate length of the congenital solitary kidney is a key parameter for maintenance of renal function and should be examined routinely during followup.
PURPOSE: We assessed renal function outcome in children with congenital solitary kidney and evaluated prognostic risk factors. MATERIALS AND METHODS: We retrospectively studied the clinical charts of 210 children presenting with congenital solitary kidney at 2 pediatric nephrology and 5 pediatric units between January 2009 and October 2012. Children 0 to 18 years old with a congenital solitary kidney confirmed by scintigraphy were enrolled. Of the patients 146 were suitable for analysis. Median followup was 4.6 years. Primary outcome was decreased estimated glomerular filtration rate, and secondary outcome was occurrence of proteinuria and/or systemic hypertension. Primary outcome-free survival analysis was performed, including multiple regression analysis of significant risk factors. RESULTS: Decreased estimated glomerular filtration rate was present in 12% of children at a median age of 2.2 years. Primary outcome-free survival analysis revealed an estimated event-free survival of 82% (95% CI 74% to 91%) at 10 years. Estimated survival rate was significantly decreased in children with additional congenital anomalies of the kidney/urinary tract (54% vs 88% overall) or insufficient renal length vs expected for normal congenital solitary kidney. The latter was the strongest predictor of decreased estimated outcome-free survival (49% vs 89%, p <0.001). Occurrence of proteinuria and/or systemic hypertension was present in less than 5% of children. CONCLUSIONS: Some children with congenital solitary kidney show decreased glomerular filtration rate. Associated anomalies of the kidney/urinary tract and insufficient renal length appear to be significant risk factors. Adequate length of the congenital solitary kidney is a key parameter for maintenance of renal function and should be examined routinely during followup.
Authors: Isabel V Poggiali; Ana Cristina Simões E Silva; Mariana A Vasconcelos; Cristiane S Dias; Izabella R Gomes; Rafaela A Carvalho; Maria Christina L Oliveira; Sergio V Pinheiro; Robert H Mak; Eduardo A Oliveira Journal: Pediatr Nephrol Date: 2018-10-15 Impact factor: 3.714
Authors: Kamal Khan; Dina F Ahram; Yangfan P Liu; Rik Westland; Rosemary V Sampogna; Nicholas Katsanis; Erica E Davis; Simone Sanna-Cherchi Journal: Kidney Int Date: 2021-11-12 Impact factor: 10.612
Authors: Sander Groen In 't Woud; Nieke Reuver; Wout F J Feitz; Josine S L T Quaedackers; Rien Nijman; Martijn Steffens; Liesbeth L L de Wall; Nel Roeleveld; Michiel F Schreuder; Loes F M van der Zanden Journal: Eur Urol Open Sci Date: 2021-10-27
Authors: Sander Groen In 't Woud; Rik Westland; Wout F J Feitz; Nel Roeleveld; Joanna A E van Wijk; Loes F M van der Zanden; Michiel F Schreuder Journal: Eur Urol Open Sci Date: 2021-02-03