Pediatric Nephrology

, Volume 29, Issue 2, pp 249–256

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

  • Ekaterini Siomou
  • Vasileios Giapros
  • Frederica Papadopoulou
  • Maria Pavlou
  • Andreas Fotopoulos
  • Antigoni Siamopoulou
Original Article

DOI: 10.1007/s00467-013-2623-4

Cite this article as:
Siomou, E., Giapros, V., Papadopoulou, F. et al. Pediatr Nephrol (2014) 29: 249. doi:10.1007/s00467-013-2623-4

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.

Keywords

Solitary kidney Unilateral renal agenesis Uninephrectomy Glomerulosclerosis Resistance index Microalbuminuria 

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

Copyright information

© IPNA 2013

Authors and Affiliations

  • Ekaterini Siomou
    • 1
  • Vasileios Giapros
    • 2
  • Frederica Papadopoulou
    • 3
  • Maria Pavlou
    • 1
  • Andreas Fotopoulos
    • 4
  • Antigoni Siamopoulou
    • 1
  1. 1.Department of PediatricsUniversity Hospital of IoanninaIoanninaGreece
  2. 2.Department of Neonatal Intensive Care UnitUniversity Hospital of IoanninaIoanninaGreece
  3. 3.Department of RadiologyUniversity Hospital of IoanninaIoanninaGreece
  4. 4.Department of Nuclear MedicineUniversity Hospital of IoanninaIoanninaGreece

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