The Inter-Relation between Solitary Kidney and Diabetes Mellitus-What Patterns are Known?

Abstract

Over the last 20 years, most of the studies regarding the kidney outcome of people with solitary kidney (SK) show that there is a progressive loss of renal function in these individuals. In order to carry out the renal work undertaken by two kidneys, SK must adapt through complex phenomena of hypertrophy and hyperfiltration. The adaptive changes are considered, "the first hit" of SK because these lead to glomerular injury with progressive loss of kidney function. Thus, more than 50% of children with congenital SK have markers of renal injury by the age of 18 years. Also, living kidney donors have 3 to 5 times higher relative risk of end stage renal disease (ESRD as compared with their counterparts with two kidneys. A "second hit", such as obesity, hypertension, and diabetes mellitus (DM), which superimpose to the SK status conducts to a faster decline in kidney function and to a poor renal prognosis of these individuals. Due to the fact that type 2 DM is a pandemic disease of the 21st century, with an increasing prevalence among SK patients, in this paper we aimed to present different patterns of the inter-relation between SK and DM.