Growth and function in childhood of a normal solitary kidney from birth or from early infancy
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- Siomou, E., Giapros, V., Papadopoulou, F. et al. Pediatr Nephrol (2014) 29: 249. doi:10.1007/s00467-013-2623-4
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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.
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.
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).
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.
KeywordsSolitary kidney Unilateral renal agenesis Uninephrectomy Glomerulosclerosis Resistance index Microalbuminuria
Body mass index
Body surface area
Diastolic blood pressure
Diethylene triamine pentaacetic acid-glomerular filtration rate
Systolic blood pressure
Small for gestation age