Congenital Solitary Kidney in Children: Size Matters

Claudio La Scola, Anita Ammenti, Giuseppe Puccio, Maria Vittoria Lega, Chiara De Mutiis, Claudia Guiducci, Laura De Petris, Rosa Perretta, Vittorio Venturoli, Gianluca Vergine, Andrea Zucchini, Giovanni Montini

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1250-1256
Number of pages7
JournalJournal of Urology
Volume196
Issue number4
DOIs
Publication statusPublished - Oct 1 2016

Keywords

  • CAKUT
  • renal insufficiency, chronic
  • ultrasonography

ASJC Scopus subject areas

  • Urology

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    La Scola, C., Ammenti, A., Puccio, G., Lega, M. V., De Mutiis, C., Guiducci, C., De Petris, L., Perretta, R., Venturoli, V., Vergine, G., Zucchini, A., & Montini, G. (2016). Congenital Solitary Kidney in Children: Size Matters. Journal of Urology, 196(4), 1250-1256. https://doi.org/10.1016/j.juro.2016.03.173