Prognosis of Children with Solitary Kidney after Unilateral Nephrectomy

Argueso, Luis R.; Ritchey, Michael L.; Boyle, Emmett T.; Milliner, Dawn S.; Bergstralh, Erik J.; Kramer, Stephen A.

doi:10.1016/s0022-5347(17)36710-1

Cited by 78 publications

(37 citation statements)

References 23 publications

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“…Results from another retrospective study on URA patients showed that 47% of individuals developed hypertension, 19% of individuals had proteinuria, 13% of individuals had an impaired GFR, and 4% of individuals died of renal failure (36). Similar findings were identified in adults with an acquired solitary functioning kidney (37). Gonzalez et al (39) showed that obesity is associated with an increase in serum creatinine and the development of proteinuria in adults with a solitary functioning kidney.…”

Section: Clinical Outcomementioning

confidence: 85%

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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Section: Clinical Outcomementioning

confidence: 85%

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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“…Children with a solitary functioning kidney of any etiology have a small increased risk of proteinuria and renal insufficiency in adulthood. 11,12 Conclusion: The contralateral kidney in those with "simple" MCDK does not warrant urological follow-up. The contralateral kidney in those with "complex" MCDK warrants urological and/or nephrological follow-up depending on the associated abnormalities identified (Level 3 evidence).…”

Section: Literature Reviewmentioning

confidence: 98%

Multicystic dysplastic kidney in the neonate: the role of the urologist

Psooy

2013

CUAJ

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“…Some investigators consider post-nephrectomy renal dysfunction as clinically insignificant (19,20). In contrast, other investigators consider this renal dysfunction to be a harbinger of longterm consequences (21,22). Romao et al (15) were the first to draw attention to the need to develop risk stratification for renal dysfunction for unilateral nonsyndromic WT patients.…”

Section: The Function Of Solitary Kidney In Wtsmentioning

confidence: 99%

Chronic Kidney Disease in Wilms Tumour Survivors – What Do We Know Today?

Stefanowicz

Kosiak

et al. 2016

Wilms Tumor

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Licence: This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0/ Users are allowed to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material for any purpose, even commercially), as long as the authors and the publisher are explicitly identified and properly acknowledged as the original source. AbstractCurrently, the treatment of Wilms tumour (WT) is successful in approximately 90% of cases, and consists of chemotherapy, nephrectomy, and, in some cases, radiation therapy. All treatments have potential long-term influence on the function of solitary kidneys in WT survivors (WTS). Severe reduction in glomerular filtration rate occurs after nephrectomy. All patients who underwent surgical treatment for WT could be considered to have 132a risk of chronic kidney disease (CKD) because they lack a kidney. End-stage renal disease is rare (1.8% of National Wilms Tumour Study patients). Recent studies have revealed that patients with CKD have a greater risk of cardiovascular events and death. Most of the WTS have lower stages or no CKD. Regular biochemical studies and ultrasound examination at follow-up visits should be considered as indispensible elements of long-term care in uninephrectomized WTS. The evaluation of a single kidney function should be frequent, consisting of the assessment of estimated glomerular filtration rate (eGFR), assessment of albumin urine excretion, urine sediment analysis to detect abnormalities, ultrasound examination and measurements of blood pressure. According to Kidney Disease Improving Global Outcomes (KDIGO) recommendation and suggestions, GFR should be assessed using GFR-estimating equations that include serum creatinine and cystatin C concentrations. Cystatin C can be a more sensitive marker of kidney filtration function than creatinine, especially in diseases characterized by a mild decrease in glomerular filtration. This will facilitate the detection of early kidney impairment and assessment of the progression of CKD in WTS.

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Prognosis of Children with Solitary Kidney after Unilateral Nephrectomy

Cited by 78 publications

References 23 publications

Clinical Implications of the Solitary Functioning Kidney

Clinical Implications of the Solitary Functioning Kidney

Multicystic dysplastic kidney in the neonate: the role of the urologist

Chronic Kidney Disease in Wilms Tumour Survivors – What Do We Know Today?

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