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Growth and function in childhood of a normal solitary kidney from birth or from early infancy

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Abstract

Background

Children with a solitary kidney (SK) have an increased long-term risk of hypertension, albuminuria and glomerulosclerosis. In this study, we assessed the early signs of impaired glomerular filtration in children with a SK from birth or from early infancy.

Methods

Renal growth and function at ages 4–15.5 years were studied in 38 children with SK and 40 matched control subjects in terms of accelerated growth.

Results

The systolic/diastolic blood pressure Z-scores (p = 0.01/<0.05) and the resistance index (RI) of the arcuate arteries (p = 0.05) were higher in the children with SK. Creatinine clearance and 24-h protein and albumin urinary excretion showed no difference. All but seven children with SK had 99mTc diethylene-triamine pentaacetic acid glomerular filtration rate values of >80 ml/min/1.73 m2. An independent positive correlation was found between length of the follow-up time and 24-h albumin urinary excretion (β = 0.54, p < 0.01). Accelerated postnatal growth was positively related with kidney volume (β = 0.35, p < 0.05).

Conclusions

Among our patient cohort, renal function was well preserved at ages 4–15.5 years in children who were born with a SK. However, both their higher blood pressure and RI and the correlation of 24-h albumin urinary excretion with length of follow-up time underline the need for monitoring to detect early signs of glomerular hyperfiltration and, if necessary, implement timely intervention. SK hypertrophy was found to be correlated with postnatal growth.

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Abbreviations

BMI:

Body mass index

BSA:

Body surface area

DBP:

Diastolic blood pressure

DTPA-GFR:

Diethylene triamine pentaacetic acid-glomerular filtration rate

eGFR:

Estimated GFR

RI:

Resistance index

SCr:

Serum creatinine

SBP:

Systolic blood pressure

SGA:

Small for gestation age

SK:

Solitary kidney

VUR:

Vesicoureteral reflux

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Authors and Affiliations

  1. Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, 45500, Ioannina, Greece

    Ekaterini Siomou, Maria Pavlou & Antigoni Siamopoulou

  2. Department of Neonatal Intensive Care Unit, University Hospital of Ioannina, Ioannina, Greece

    Vasileios Giapros

  3. Department of Radiology, University Hospital of Ioannina, Ioannina, Greece

    Frederica Papadopoulou

  4. Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece

    Andreas Fotopoulos

Authors
  1. Ekaterini Siomou
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  2. Vasileios Giapros
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  4. Maria Pavlou
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  6. Antigoni Siamopoulou
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Correspondence to Ekaterini Siomou.

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Siomou, E., Giapros, V., Papadopoulou, F. et al. Growth and function in childhood of a normal solitary kidney from birth or from early infancy. Pediatr Nephrol 29, 249–256 (2014). https://doi.org/10.1007/s00467-013-2623-4

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  • DOI: https://doi.org/10.1007/s00467-013-2623-4

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