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Towards adulthood with a solitary kidney

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Abstract

Around 1/1000 people have a solitary kidney. Congenital conditions mainly include multicystic dysplastic kidney and unilateral renal aplasia/agenesis; acquired conditions are secondary to nephrectomy performed because of urologic structural abnormalities, severe parenchymal infection, renal trauma, and renal or pararenal tumors. Children born with congenital solitary kidney have a better long-term glomerular filtration rate than those with solitary kidney secondary to nephrectomy later in life. Acute and chronic adaptation processes lead to hyperfiltration followed by fibrosis in the remnant kidney, with further risk of albuminuria, arterial hypertension, and impaired renal function. Protective measures rely on non-pharmacological renoprotection (controlled protein and sodium intake, avoidance/limitation of nephrotoxic agents, keeping normal body mass index, and limitation of tobacco exposure). Lifelong monitoring should include blood pressure and albuminuria assessment, completed by glomerular filtration rate (GFR) estimation in case of abnormal values. In the absence of additional risk factors to solitary kidney, such assessment can be proposed every 5 years. There is no current consensus for indication and timing of pharmacological intervention.

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References

  1. Hedge S, Coulthard MG (2009) Renal agenesis and unilateral nephrectomy: what are the risks of living with a single kidney? Pediatr Nephrol 24:439–446

    Google Scholar 

  2. Hilliard SA, El-Dahr SS (2016) Epigenetics mechanisms in renal development. Pediatr Nephrol 31:1055–1060

    PubMed  Google Scholar 

  3. Minuth W (2018) Reading first coordinates from the nephrogenic zone in human fetal kidney. Nephron 138:137–146

    PubMed  Google Scholar 

  4. Bertram JF, Cullen-McEwen LA, Egan GF, Gretz N, Baldelomar E, Beeman SC, Bennett KM (2014) Why and how we determine nephron number. Pediatr Nephrol 29:575–580

    PubMed  Google Scholar 

  5. van Vuuren SH, Sol CM, Broekhuizen R, Lilien M, Oosterveld MJS, Nguyen TQ, Goldschmeding R, de Jong TPVM (2012) Compensatory growth of congenital solitary kidneys in pigs reflects increased nephron numbers rather than hypertrophy. PLoS One 7:e49735

    PubMed  PubMed Central  Google Scholar 

  6. Tsuboi N, Kanzaki G, Koike K, Kawamura T, Ogura M, Yokoo T (2014) Clinicopathological assessment of the nephron number. Clin Kidney J 7:107–114

    PubMed  PubMed Central  Google Scholar 

  7. Rodenbach KE, Fuhrman DY, Maier PS, Schwartz GJ (2017) Renal response to a protein load in healthy young adults as determined by iohexol infusion clearance, cimetidine-inhibited creatinine clearance, and cystatin C estimed glomerular filtration rate. J Ren Nutr 27:275–281

    CAS  PubMed  Google Scholar 

  8. Schreuder MF, Westland R, van Wijk JA (2009) Unilateral multicystic dysplastic kidney: a meta-analysis of observational studies on the incidence associated urinary tract malformations and the contralateral kidney. Nephrol Dial Transplant 24:1810–1818

    PubMed  Google Scholar 

  9. Woolf AS, Hillman KA (2007) Unilateral renal agenesis and the congenital solitary functioning kidney: developmental, genetic and clinical perspectives. BJU Int 99:17–21

    CAS  PubMed  Google Scholar 

  10. Westland R, Schreuder MF, Bökenkamp A, Spreeuwenberg MD, van Wijk JAE (2011) Renal injury in children with a solitary functioning kidney-the KIMONO study. Nephrol Dial Transplant 26:1533–1541

    PubMed  Google Scholar 

  11. Dogan CS, Torun-Bayram M (2013) Renal outcome of children with unilateral agenesis. Turk J Pediatr 55:612–615

    PubMed  Google Scholar 

  12. Sanna-Cherchi S, Ravani P, Corbani V, Parodi S, Haupt R, Piaggio G, Degli Innocenti ML, Somenzi D, Trivelli A, Caridi G, Izzi C, Scolari F, Mattioli G, Allegri L, Ghiggeri GM (2009) Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int 76:528–533

    PubMed  Google Scholar 

  13. Flögelová H, Langer J, Šmakal O, Michálková K, Bakaj-Zbrožková L, Zapletalová J (2014) Renal parenchymal thickness in children with solitary functioning kidney. Pediatr Nephrol 29:241–248

    PubMed  Google Scholar 

  14. Wühl E, van Stralen KJ, Verrina E, Bjerre A, Wanner C, Heaf JG, Zurriaga O, Hoitsma A, Niaudet P, Palsson R, Ravani P, Jager KJ, Schaefer F (2013) Timing and outcome of renal replacement therapy in patients with congenital malformations of the kidney and urinary tract. Clin J Am Soc Nephrol 8:67–74

    PubMed  Google Scholar 

  15. Chung BH, Yu JH, Cho HJ, Kim JI, Moon IS, Park CW, Yang CW, Kim YS, Choi BS (2013) Comparison of estimating equations for the prediction of glomerular filtration rate in kidney donors before and after kidney donation. PLoS One 8:e60720

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Ghane Shrarbaf F, Bitzan M, Szymanski KM, Bell LE, Gupta I, Tchervenkov J, Capolicchio JP (2012) Native nephrectomy priori to pediatric kidney transplantation: biological and clinical aspects. Pediatr Nephrol 27:1179–1188

    Google Scholar 

  17. Fraser N, Lyon PC, Williams AR, Christian MT, Shenoy MU (2012) Native nephrectomy in pediatric renal transplantation – less is more! J Pediatr Urol 9:84–89

    PubMed  Google Scholar 

  18. Wesson DE, Jo CH, Simoni J (2015) Angiotensin II-mediated GFR decline in subtotal nephrectomy is due to acid retention associated with reduced GFR. Nephrol Dial Transplant 30:762–770

    CAS  PubMed  Google Scholar 

  19. Mueller TF, Luyckx VA (2012) The natural history of residual renal function in transplant donors. J Am Soc Nephrol 23:1462–1466

    PubMed  Google Scholar 

  20. Patel N, Mason P, Rushton S, Hudson A, Ploeg R, Friend P, Sinha S, Sullivan M (2013) Renal function and cardiovascular outcomes after living donor nephrectomy in the UK: quality and safety revisited. BJU Int 112:E134–E142

    PubMed  Google Scholar 

  21. Lankadeva YR, Singh RR, Tare M, Moritz KM, Denton KM (2014) Loss of a kidney during fetal life: long-term consequences and lessons learned. Am J Renal Physiol 306:F791–F800

    CAS  Google Scholar 

  22. Abou-Jaoudé P, Dubourg L, Bacchetta J, Berthillier J, Ranchin B, Cochat P (2011) Congenital versus acquired solitary kidney: is the difference relevant? Nephrol Dial Transplant 26:2188–2194

    PubMed  Google Scholar 

  23. Wasilewska A, Zoch-Zwierz W, Jadeszko I, Porowski T, Biernacka A, Niewiarowska A, Korzeniecka-Kozerska A (2006) Assessment of serum cystatin C in children with congenital solitary kidney. Pediatr Nephrol 21:688–696

    PubMed  Google Scholar 

  24. Kelly DJ, Hepper C, Wu LL, Cox AJ, Gilbert RE (2003) Vascular endothelial growth factor expression and glomerular endothelial cell loss in the remnant kidney model. Nephrol Dial Transplant 18:1286–1292

    CAS  PubMed  Google Scholar 

  25. Yang B, El Nahas AM, Thomas GL, Haylor JL, Watson PF, Wagner B, Johnson TS (2001) Caspase-3 and apoptosis in experimental chronic renal scarring. Kidney Int 60:1765–1776

    CAS  PubMed  Google Scholar 

  26. Schnaper HW (2014) Remnant nephron physiology and the progression of chronic kidney disease. Pediatr Nephrol 29:193–202

    PubMed  Google Scholar 

  27. Kusaba T, Humphreys BD (2014) Controversies on the origin of proliferating epithelial cells after kidney injury. Pediatr Nephrol 29:673–679

    PubMed  Google Scholar 

  28. Piepz A, Prigent A, Hall M, Ismaili K, Collier F, Ham H (2005) At what level of unilateral renal impairment does compensatory functional compensation occur? Pediatr Nephrol 20:1593–1598

    Google Scholar 

  29. Wilson BE, Davies P, Shah K, Wong W, Taylor M (2003) Renal length and inulin clearance in the radiologically normal single kidney. Pediatr Nephrol 18:1147–1151

    PubMed  Google Scholar 

  30. Donckerwolcke RM, Coppes MJ (2001) Adaptation of renal function after unilateral nephrectomy in children with renal tumors. Pediatr Nephrol 16:568–574

    CAS  PubMed  Google Scholar 

  31. Siomou E, Giapros V, Papadopoulou F, Pavlou M, Fotopoulos A, Siamopoulou A (2014) Growth and function in childhood of a normal solitary kidney from birth or from early infancy. Pediatr Nephrol 29:249–256

    PubMed  Google Scholar 

  32. Taranta-Janusz K, Zalewska-Szajda B, Gościk E, Chojnowska S, Dmochowska M, Pszczółkowska M, Wasilewska A (2014) New tubular injury markers in children with a solitary functioning kidney. Pediatr Nephrol 29:1599–1605

    PubMed  PubMed Central  Google Scholar 

  33. Haylor JL, McKillop IH, Oldroyd SD, El Nahas MA (2000) IGF-I inhibitors reduce compensatory hyperfiltration in the isolated rat kidney following unilateral nephrectomy. Nephrol Dial Transplant 15:87–92

    CAS  PubMed  Google Scholar 

  34. Li HY, Hou FF, Zhang X, Chen PY, Liu SX, Feng JX, Liu ZQ, Shan YX, Wang GB, Zhou ZM, Tian JW, Xie D (2007) Advanced oxidation protein products accelerate renal fibrosis in a remnant kidney model. J Am Soc Nephrol 18:528–538

    CAS  PubMed  Google Scholar 

  35. Yu XQ, Wu LL, Huang XR, Yang N, Gilbert RE, Cooper ME, Johnson RJ, Lai KN, Lan HY (2000) Osteopontin expression in progressive renal injury in remnant kidney: role of angiotensin 2. Kidney Int 58:1469–1480

    CAS  PubMed  Google Scholar 

  36. Amann K, Rump LC, Viviene AS, Oberhauser V, Wessels S, Orth SR, Gross ML, Koch A, Bielenberg GW, van Katz JP, Ehmke H, Mall G, Ritz E (2000) Effects of low dose sympathetic inhibition on glomerulosclerosis and albuminuria in subtotally nephrectomized rats. J Am Soc Nephrol 11:1469–1478

    CAS  PubMed  Google Scholar 

  37. Keller G, Zimmer G, Mall G, Ritz E, Amann K (2003) Nephron number in patients with primary hypertension. N Engl J Med 348:101–108

    PubMed  Google Scholar 

  38. Moritz KM, Jefferies A, Wong J, Wintour EM, Dodic M (2005) Reduced renal reserve and increased cardiac output in adult female sheep uninephrectomized as fetuses. Kidney Int 76:822–828

    Google Scholar 

  39. Griffin KA, Picken MM, Churchill M, Churchill P, Bidani AK (2000) Functional and structural correlates of glomerulosclerosis after renal mass reduction in the rat. J Am Soc Nephrol 11:497–506

    CAS  PubMed  Google Scholar 

  40. Dursun H, Bayazit AK, Cengiz N, Seydaoglu G, Buyukcelik M, Soran M, Noyan A, Anarat A (2007) Ambulatory blood pressure monitoring and renal functions in children with a solitary kidney. Pediatr Nephrol 22:559–564

    PubMed  PubMed Central  Google Scholar 

  41. Mei-Zavah M, Korzets Z, Cohen I, Kessler O, Rathaus V, Wolach B, Pomeranz A (2001) Ambulatory blood pressure monitoring in children with a solitary kidney – a comparison between unilateral renal agenesis and uninephrectomy. Blood Press Monit 6:263–267

    Google Scholar 

  42. Westland R, Schreuder MF, van der Lof DF, Vermeulen A, Dekker-van der Meer IMJ, Bökenkamp A, van Wijk AE (2014) Ambulatory blood pressure monitoring is recommended in the clinical management of children with a solitary functioning kidney. Pediatr Nephrol 29:2205–2211

    PubMed  Google Scholar 

  43. Hemmelgarn BR, Zhang J, Manns BJ, Tonelli M, Larsen E, Ghali WA, Southern DA, McLaughlin K, Mortis G, Culleton BF (2006) Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int 69:2155–2161

    CAS  PubMed  Google Scholar 

  44. Westland R, Kurvers RAJ, van Wijk JAE, Schreuder MF (2013) Risk factors for renal injury in children with a solitary functioning kidney. Pediatrics 131:e478–e485

    PubMed  Google Scholar 

  45. Kummer S, von Gersdorff G, Kemper MJ, Oh J (2012) The influence of gender and sexual hormones on incidence and outcome of chronic kidney disease. Pediatr Nephrol 27:1213–1219

    PubMed  Google Scholar 

  46. Peco-Antić A, Paripović D, Kotur-Stevuljević J, Stefanović A, Sćekić G, Miloševski-Lomić G (2012) Renal functional reserve in children with apparently normal congenital solitary functioning kidney. Clin Biochem 45:1173–1177

    PubMed  Google Scholar 

  47. Taranta-Janusz K, Wasilewska A, Stypułkowska J, Sutula M (2012) Osteopontin and symmetric dimethylarginine plasma levels in solitary functioning kidney in children. Acta Paediatr 101:e369–e372

    CAS  PubMed  Google Scholar 

  48. Wasilewska A, Zoch-Zwierz W, Taranta-Janusz K (2009) Urinary transforming growth factor beta1 in children and adolescents with congenital solitary kidney. Pediatr Nephrol 24:753–759

    PubMed  Google Scholar 

  49. Schreuder MF, Langemeijer ME, Bökenkamp A, Delemarre-Van de Waal HA, Van Wijkl JA (2008) Hypertension and microalbuminuria in children with congenital solitary kidneys. J Paediatr Child Health 44:363–368

    PubMed  Google Scholar 

  50. Wikstad I, Celsi G, Larsson L, Herin P, Aperia A (1988) Kidney function in adults born with unilateral renal agenesis or nephrectomized in childhood. Pediatr Nephrol 2:177–182

    CAS  PubMed  Google Scholar 

  51. Wikstad I, Pettersson BA, Elinder G, Sökücü S, Aperia A (1986) A comparative study of size and function of the remnant kidney in patients nephrectomized in childhood for Wilms tumor and hydronephrosis. Acta Paediatr Scand 75:408–414

    CAS  PubMed  Google Scholar 

  52. Robitaille P, Mongeau JG, Lortie L, Sinassamy P (1985) Long-term follow-up of patients who underwent unilateral nephrectomy in childhood. Lancet 1:1297–1299

    CAS  PubMed  Google Scholar 

  53. Stefanowicz J, Owczuk R, Kalużyńska B, Aleksandrowicz-Drożyńska E, Balcerska A (2012) Renal function and solitary kidney disease: Wilms tumour survivors versus patients with unilateral renal agenesis. Kidney Blood Press Res 35:174–181

    PubMed  Google Scholar 

  54. Akl K (2011) The anomalies associated with congenital solitary functioning kidney in children. Saudi J Kidney Dis Transpl 22:67–71

    PubMed  Google Scholar 

  55. Spira EM, Jacobi C, Frankenschmidt A, Pohl M, von Schnakenburg C (2009) Sonographic long-term study: paediatric growth charts for single kidneys. Arch Dis Child 94:693–698

    CAS  PubMed  Google Scholar 

  56. Hellerstein S, Chambers L (2008) Solitary kidney. Clin Pediatr (Phila) 47:652–658

    Google Scholar 

  57. Vu KH, Van Dyck M, Daniels H, Proesmans W (2008) Renal outcome of children with one functioning kidney from birth. A study of 99 patients and a review of the literature. Eur J Pediatr 167:885–990

    PubMed  Google Scholar 

  58. Aslam M, Watson AR (2006) Unilateral multicystic dysplastic kidney: long term outcomes. Arch Dis Child 91:820–823

    CAS  PubMed  PubMed Central  Google Scholar 

  59. de Lucas C, Nocea A, San RJ, Espìnola B, Ecijan JL, Vázquez Martul M (2006) Solitary kidney. Study of renal morphology and function in 95 children. Nefrologia 26:56–63

    PubMed  Google Scholar 

  60. Seeman T, Patzer L, John U, Dušek J, Vondrák K, Janda J, Misselwitz J (2006) Blood pressure, renal function, and proteinuria in children with unilateral renal agenesis. Kidney Blood Press Res 29:210–215

    PubMed  Google Scholar 

  61. Godbole PP, Wilcox DT, Mushtaq I (2005) Follow-up after unilateral nephrectomy in children: is an estimate of glomerular filtration rate necessary? BJU Int 95:635–637

    PubMed  Google Scholar 

  62. Kuwertz-Broeking E, Brinkmann OA, Von Lengerke HJ, Sciuk J, Fruend S, Bulla M, Harms E, Hertle L (2004) Unilateral multicystic dysplastic kidney: experience in children. BJU Int 93:388–392

    CAS  PubMed  Google Scholar 

  63. Feldenberg LR, Siegel NJ (2000) Clinical course and outcome for children with multicystic dysplastic kidneys. Pediatr Nephrol 14:1098–1101

    CAS  PubMed  Google Scholar 

  64. Baudoin P, Provoost AP, Molenaar JC (1993) Renal function up to 50 years after unilateral nephrectomy in childhood. Am J Kidney Dis 21:603–611

    CAS  PubMed  Google Scholar 

  65. Argueso LR, Richtey ML, Boyle ET, Milliner DS, Bergstralh EJ, Kramer SA (1992) Prognosis of children with solitary kidney after unilateral nephrectomy. J Urol 148:747–751

    CAS  PubMed  Google Scholar 

  66. Argueso LR, Richtey ML, Boyle ET, Milliner DS, Bergstralh EJ, Kramer SA (1992) Prognosis of patients with unilateral renal agenesis. Pediatr Nephrol 6:412–416

    CAS  PubMed  Google Scholar 

  67. Mjøen G, Hallan S, Hartmann A, Foss A, Midtvedt K, Øyen O, Reisæter A, Pfeffer P, Jenssen T, Leivestad T, Line PD, Øvrehus M, Dale DO, Pihlstrøm H, Holme I, Dekker FW, Holdaas H (2014) Long term risks for kidney donors. Kidney Int 86:162–167

    PubMed  Google Scholar 

  68. Muzaale AD, Massie AB, Wang MC, Montgomery MA, McBride MA, Wainright JL, Segev DL (2014) Risk of end-stage renal disease following live kidney donation. JAMA 311:579–586

    CAS  PubMed  PubMed Central  Google Scholar 

  69. Ibrahim HN, Foley R, Tan L, Rogers T, Bailey RF, Guo H, Gross CR, Matas AJ (2009) Long-term consequences of kidney donation. N Engl J Med 360:459–469

    CAS  PubMed  PubMed Central  Google Scholar 

  70. Podjarny E, Bernheim J, Hasdan G, Karsh D, Rashid G, Green J, Katz B, Bernheim J (2007) Additive renoprotective effect of candesartan and tetrahydrobiopterin in rats after 5/6 nephrectomy. Nephrol Dial Transplant 22:1864–1872

    CAS  PubMed  Google Scholar 

  71. Lin SL, Chen YM, Chien CT, Chiang WC, Tsai CC, Tsai TJ (2002) Pentoxifylline attenuated the renal progression in rats with remnant kidney. J Am Soc Nephrol 13:2916–2929

    CAS  PubMed  Google Scholar 

  72. Antus B, Hamar P, Kokeny G, Szollosi Z, Mucsi I, Nemes Z, Rosivall L (2003) Estradiol is nephroprotective in the rat remnant kidney. Nephrol Dial Transplant 18:54–61

    CAS  PubMed  Google Scholar 

  73. Fujihara CK, De Lourdes Noronha IL, Avancini Costa Malheiros DM, Rutigliano Antunes G, Braga de Oliveira I, Zatz R (2000) Combined mycophénolate mofetil and losartan therapy arrests established injury in the remnant kidney. J Am Soc Nephrol 11:283–290

    CAS  PubMed  Google Scholar 

  74. Adamczak M, Gross ML, Krtil J, Koch A, Tyralla K, Amann K, Ritz E (2003) Reversal of glomerulosclerosis after high-dose enalapril treatment in subtotally nephrectomized rats. J Am Soc Nephrol 14:2833–2842

    CAS  PubMed  Google Scholar 

  75. Ibrahim HN, Hostetter TH (2000) Role of dietary potassium in the hyperaldostéronisme and hypertension of the remnant kidney model. J Am Soc Nephrol 11:625–631

    CAS  PubMed  Google Scholar 

  76. Jaramillo-Juárez F, Rodríguez-Vásquez NMC, Martín D, Reyes JL (2000) Acidosis and weight loss are induced by cyclosporin A in uninephrectomized rats. Pediatr Nephrol 14:122–127

    PubMed  Google Scholar 

  77. Shirzai A, Yildiz N, Biyikli N, Ustunsoy S, Benzer M, Alpay H (2014) Is microalbuminuria a risk factor for hypertension in children with solitary kidney? Pediatr Nephrol 29:283–288

    PubMed  Google Scholar 

  78. Hogg RJ, Furth S, Lemley KV, Portman R, Schwartz GJ, Coresh J, Balk E, Lau J, Levin A, Kautz AT, Eknoyan G, Levey AS (2003) National Kidney Foundation’s kidney disease outcomes quality initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics 111:1416–1421

    PubMed  Google Scholar 

  79. Schwartz GJ, Muñoz A, Schneider MF, Mak RH, Kaskel F, Warady BA, Furth SL (2009) New equations to estimate GFR in children with CKD. J Am Soc Nephrol 20:629–637

    PubMed  PubMed Central  Google Scholar 

  80. Westland R, Abraham Y, Bökenkamp A, Stoffel-Wagner B, Schreuder MF, van Wijk JAE (2013) Precision of estimating equations for GFR in children with a solitary kidney: the KIMONO study. Clin J Am Soc Nephrol 8:764–772

    CAS  PubMed  PubMed Central  Google Scholar 

  81. Zapitelli M, Parvex P, Joseph L, Paradis G, Grey V, Lau S, Bell L (2006) Derivation and validation of cystatin C-based prediction equations for GFR in children. Am J Kidney Dis 48:221–230

    Google Scholar 

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Authors and Affiliations

  1. Centre de référence des maladies rénales rares Néphrogones, Hospices Civils de Lyon, Lyon, France

    Pierre Cochat, Justine Bacchetta, Natalia Cabrera & Laurence Dubourg

  2. EPICIME Epidémiologie Pharmacologie Investigation Clinique Information Médicale de l’Enfant, Hospices Civils de Lyon, Lyon, France

    Pierre Cochat, Olivia Febvey & Justine Bacchetta

  3. Université Claude-Bernard Lyon 1, Lyon, France

    Pierre Cochat, Justine Bacchetta & Laurence Dubourg

  4. Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, 69677, Bron Cedex, France

    Pierre Cochat

  5. Néphrologie pédiatrique, CHU Lenval, Nice, France

    Etienne Bérard

  6. Exploration fonctionnelle rénale, Hospices Civils de Lyon, Lyon, France

    Laurence Dubourg

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  1. Pierre Cochat
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  2. Olivia Febvey
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Cochat, P., Febvey, O., Bacchetta, J. et al. Towards adulthood with a solitary kidney. Pediatr Nephrol 34, 2311–2323 (2019). https://doi.org/10.1007/s00467-018-4085-1

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