Risk Factors for Renal Injury in Children With a Solitary Functioning Kidney

Westland, Rik; Kurvers, Roel A. J.; Wijk, J. A. E. van; Schreuder, Michiel F.

doi:10.1542/peds.2012-2088

Cited by 115 publications

(116 citation statements)

References 45 publications

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“…A significantly impaired eGFR was defined as an eGFR <60ml/min/1.73m 2 (chronic kidney disease stage 3-4). Renal injury was defined as persistent presence of any of the following: hypertension and/or severely increased albuminuria and/or a significantly impaired eGFR and/or use of antihypertensive or antiproteinuric medication [21]. Angiotensin converting enzyme inhibitors were indicated if hypertension was present as defined in the fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents [23] or if albuminuria reached severely increased level according to the KDIGO definition [22].…”

Section: Methodsmentioning

confidence: 99%

“…In 2009 Sanna-Cherchi et al presented their renal survival analysis in patients born with one kidney, showing that 50% of these patients needed dialysis by the age of 30 years old, a result which highlighted potential subclinical renal defects [20]. Recent findings of Westland et al showed a median time to renal injury of 14.8 years (14.9 years for congenital SFK) [21]. Due to differences in sampling and design, however, these findings cannot be fully compared, and further evidence on this issue is lacking.…”

Section: Introductionmentioning

confidence: 99%

“…KDIGO experts have recently published a consensus guideline defining ‘albuminuria' as moderately (>30mg/24hours) or severely increased (>300mg/24hours) and highlighted adverse consequences in people with albumin excretion and/or GFR <60ml/min/1.73m 2 irrespective of the etiology or duration of reduced kidney function [22]. Thus, this study aims to assess the cumulative incidence of elevated albuminuria and hypertension and decreased GFR in SFK children in order to identify possible renal injury during childhood using a similar methodology as Westland et al [21]. …”

Section: Introductionmentioning

confidence: 99%

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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: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Solitary Functioning Kidney in Children - A Follow-Up Study

Kolvek

Podracká

Rosenberger

et al. 2014

Kidney Blood Press Res

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“…Erken dönemde hiperfiltrasyon ve kompansatris hipertrofi ile böbrek fonksiyonlarının idamesi sağlanırken, uzun dönemde hiperfiltrasyona sekonder renal hasar bulguları geliş-meye başlar (4,5) . Bu çalışmada renal kitlesi azalmış olan tek böbreği olmayan renal agenezili hastalar ve yapısal olarak küçük olan tek taraflı hipoplazili hastaların böbrek fonksiyonları normal olmasına rağ-men, her iki grupta eGFR ye göre 29 (%58) hastada hiperfiltrasyon ve 21 (%42) hastada kompansatris hipertrofi saptandı.…”

Section: Discussionunclassified

“…Tek taraflı agenezik ve hipoplazik böbrekli hastalar uzun dönemde, azalmış nefron sayısını kompanse etmek için gelişen glomerüler hiperfiltrasyona ve artmış glomerül boyutuna sekonder gelişen fokal segmental glomerüloskleroz (FSGS) nedeni ile kronik böbrek yetmezliği gelişme riskini artırır. Bu olguların yaklaşık %25'i son dönem böbrek yetmezliğine ilerler (3)(4)(5)(6) . Bu çalışmada, tek taraflı agenezik ve hipoplazik böbreği olan hastaların klinik özelliklerinin ve izlem sonuçlarının değerlendirilmesi planlandı.…”

Section: Introductionunclassified

Clinical characteristics and follow-up results of unilateral renal agenesis and hypoplasia of children

Evrengül¹,

Ertan²,

Serdaroğlu³

et al. 2016

BUCH

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ÖZAmaç: Az nefron sayısına sahip çocuklarda, yaşamlarının ilerleyen dönemlerinde hipertansiyon, proteinüri ve kronik böbrek yetmezliği gelişme riski yüksektir. Bu renal hasar, glomerüler hiperfiltrasyondam kaynaklanmaktadır. Bu çalışmanın amacı, tek taraflı agenezik ve hipoplazik böbreği olan çocukların klinik özelliklerinin ve izlem sonuçlarının değerlendirilmesidir. Yöntem: Celal Bayar Üniversitesi Tıp Fakültesi ve Dr. Behçet Uz Çocuk Hastanesinde takip edilen, tek taraflı renal agenezisi ve hipoplazisi olan hastaların klinik, radyolojik ve nükleer tıp inceleme bulguları değerlendirildi. Bulgular: Bu çalışma ortalama yaşı 8,9±4 yıl olan 30 (%60) erkek ve 20 (%40) kız hastadan oluşmaktaydı. Yirmi beş hasta renal agenezi, 25 hasta renal hipoplazi tanısı aldı. Laboratuvar incelemesinde ortalama serum kreatinin düzeyi 0,45±0,22 mg/dl ve tahmin edilen glomerüler filtrasyon hızı (eGFR) 144±30,3 ml/dk. idi. Yirmi dokuz (%58) hastada hiperfiltrasyon saptandı. Proteinüri ve hipertansiyonu olan 1 (%4) hasta vardı. On beş (%30) hastada ürolojik anamoli mevcuttu. Sonuç: Bu çalışmada, tek taraflı renal agenezisi ve hipoplazisi olan hastaların serum kreatinin düzeyi normal bulundu. Ancak bu hastaların 29 (%58) hiperfiltrasyon vardı. Hiperfiltasyonu olan çocukların çoğunda yaşamlarının ilerleyen döneminde renal hasar geliştiği için bu çocuk-ların doğumdan itibararen klinik takiplerinin yapılması gerekmektedir.Anahtar kelimeler: Konjenital böbrek hastalıkları, renal agenezi, renal hipoplazi ABSTRACT Objective: Children with an inadequate number of nephrons have an increased risk of developing hypertension, proteinuria and chronic kidney disease in later life. This renal injury is caused by glomerular hyperfiltration. The aim of this study is to evaluate clinical characteristics and follow-up results of the children with unilateral renal agenesis and hypoplasia. Methods: We evaluated the clinical, radiological, and nuclear medicine findings of the children with unilateral agenetic or hypoplastic kidneys who were followed at Celal Bayar University School of Medicine and Dr. Behcet Uz Children's Hospital between 2005 and 2012. Results: The study consisted of 30 (60%) males and 20 (40%) females with a mean age of 8.9±4 years. A total of 25 patients were with renal agenesis and 25 with renal hypoplasia were diagnosed. On laboratory evaluation, mean serum creatinine level was 0.45±0.22 mg/ dl and the mean estimated glomerular filtration rate (eGFR) was 144±30.3 ml/min. 29 patient (58%) had hyperfiltration according to an eGFR. Proteinuria and hypertension were noted in 1 (4%) patient. Urological anomalies were found in 15 patients (30%). Conclusion: Our study has determined that children with unilateral renal agenesis and hypoplasia had normal serum creatinine values. Howewer 29 patients (58%) had hyperfiltration according to eGFR. Because many children with hiperfiltration develop renal injury in later life, we emphasize the need for clinical follow-up in these patients starting at birth.

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Kidney, Urinary Bladder, and Ureter

Ardalan

2016

Bergman's Comprehensive Encyclopedia of Human Anatomic Variation

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Risk Factors for Renal Injury in Children With a Solitary Functioning Kidney

Abstract: Our study determines independent risk factors for renal injury in children with a solitary functioning kidney. Because many children develop renal injury, we emphasize the need for clinical follow-up in these patients starting at birth.

Cited by 115 publications

References 45 publications

Solitary Functioning Kidney in Children - A Follow-Up Study

Solitary Functioning Kidney in Children - A Follow-Up Study

Clinical characteristics and follow-up results of unilateral renal agenesis and hypoplasia of children

Kidney, Urinary Bladder, and Ureter

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