'Congenital solitary functioning kidneys: which ones warrant follow-up into adult life?'

Corbani, Valentina; Sanna‐Cherchi, Simone

doi:10.1093/ndt/gfr145

Cited by 20 publications

(17 citation statements)

References 13 publications

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“…Our results support the need for a close follow-up of SFK patients, especially those with CAKUT in the SFK, as suggested by Corbani and Westland and many others [21,33,34], since at least a portion of these patients have an unfavorable prognosis and should be monitored more closely. As the accuracy of the creatinine-based equations is limited when GFR decreases, follow-up using a combined serum cystatin C/creatinine-based equation is recommended, if available [35,36].…”

Section: Discussionsupporting

confidence: 89%

Solitary Functioning Kidney in Children - A Follow-Up Study

Kolvek

Podracká

Rosenberger

et al. 2014

Kidney Blood Press Res

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Background/Aims: This study aims to assess the cumulative incidence of elevated albuminuria, hypertension and decreased estimated glomerular filtration rate (eGFR) to identify possible renal injury in children with SFK. Methods: Forty-two children with SFK (23 boys; 27 congenital) were included in a prospective follow-up study. Blood pressure, albuminuria and eGFR were assessed repeatedly and the cumulative incidence rate of various forms of renal injury, overall and by type of etiology, were evaluated. Finally, renal injury-free survival was analyzed. Results: Mean follow-up was until age 11.3 years (SD 6.3 years). During follow-up, 16 (38.1%) patients met the criteria for renal injury, defined as hypertension (10; 23.8%), severely increased albuminuria (3; 7.1%) and a significantly impaired eGFR (<60ml/min/1.73m²) (5; 11.9%) and/or use of antihypertensive or antiproteinuric medication (11; 26.2%). Children with CAKUT in SFK had a significantly higher incidence of renal injury. The median time to develop renal injury was 12.8 years. Conclusion: A substantial proportion of children with SFK develop renal injury during childhood, especially those with CAKUT in the SFK. Therefore, close follow-up of albuminuria, blood pressure and eGFR are warranted to identify chronic kidney disease in its early stages.

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Section: Discussionsupporting

confidence: 89%

Solitary Functioning Kidney in Children - A Follow-Up Study

Kolvek

Podracká

Rosenberger

et al. 2014

Kidney Blood Press Res

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“…However, the need for regular clinical follow-up in these patients is increasingly recognized (11,45,49).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, observational studies are susceptible to selection and ascertainment bias. The number of longitudinal prospective studies on the clinical outcome of solitary functioning kidney patients is limited because of the decades required for follow-up (45). A longitudinal study on renal outcome in CAKUT showed that 20%-50% of solitary functioning kidney patients were on renal replacement therapy at the age of 30 years (2).…”

Section: Clinical Outcomementioning

confidence: 99%

Clinical Implications of the Solitary Functioning Kidney

Westland

Schreuder

Goudoever

et al. 2014

Clinical Journal of the American Society of Nephrology

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Congenital anomalies of the kidney and urinary tract are the major cause of ESRD in childhood. Children with a solitary functioning kidney form an important subgroup of congenital anomalies of the kidney and urinary tract patients, and a significant fraction of these children is at risk for progression to CKD. However, challenges remain in distinguishing patients with a high risk for disease progression from those patients without a high risk of disease progression. Although it is hypothesized that glomerular hyperfiltration in the lowered number of nephrons underlies the impaired renal prognosis in the solitary functioning kidney, the high proportion of ipsilateral congenital anomalies of the kidney and urinary tract in these patients may further influence clinical outcome. Pathogenic genetic and environmental factors in renal development have increasingly been identified and may play a crucial role in establishing a correct diagnosis and prognosis for these patients. With fetal ultrasound now enabling prenatal identification of individuals with a solitary functioning kidney, an early evaluation of risk factors for renal injury would allow for differentiation between patients with and without an increased risk for CKD. This review describes the underlying causes and consequences of the solitary functioning kidney from childhood together with its clinical implications. Finally, guidelines for follow-up of solitary functioning kidney patients are recommended.

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“…8 In addition, a recent study demonstrated that 20% to 50% of the study young adults with a congenital SFK required dialysis by the age of 30 years, 9 leading to the advice to monitor all patients with an SFK from childhood. 10,11 To guide the timing and frequency of clinical follow-up, information is needed on the age at which renal injury presents and on clinical factors that differentiate between children with and without renal injury.…”

mentioning

confidence: 99%