Solitary kidney and risk of chronic kidney disease

  • Seolhye Kim
  • Yoosoo ChangEmail author
  • Young Rae Lee
  • Hyun-Suk Jung
  • Young Youl Hyun
  • Kyu-Beck Lee
  • Kwan Joong Joo
  • Kyung Eun Yun
  • Hocheol Shin
  • Seungho RyuEmail author


The renal outcome of solitary kidney remains controversial. We examined the longitudinal association of congenital or acquired solitary kidney with the development of chronic kidney disease (CKD). A cohort study was performed involving 271,171 Korean men and women free of CKD at baseline who underwent a health screening program and who were followed annually or biennially for an average of 5.4 years. Solitary kidney was determined based on ultrasonographic findings. CKD was defined as an estimated glomerular filtration rate of < 60 ml/min/1.73 m2 and/or the presence of proteinuria in two or more consecutive visits. During 1,472,519.6 person-years of follow-up, 2989 participants developed CKD (incidence rate: 2.0 per 1000 person-years). After adjustment for potential confounders, the aHR (95% CIs) for incident CKD comparing solitary kidney to the control was 3.26 (1.63–6.54). In analyses of cause-specific solitary kidney, aHR (95% CIs) for CKD comparing unilateral nephrectomy and congenital solitary kidney to the control were 6.18 (2.31–16.49) and 2.22 (0.83–5.92), respectively. The association between solitary kidney and CKD was stronger in men. Having a solitary kidney was independently associated with an increased risk of CKD development. Therefore, preventive strategies for reducing the risk of CKD are required in individuals with a solitary kidney.


Solitary kidney Chronic kidney disease Cohort study 


Author contributions

Research idea and study design: SK, YC, SR; data analysis/interpretation: SK, YC, YRL, YC, KEY, HSJ; statistical analysis: SR; supervision or mentorship: SR, YRL, YYH, KBL, KJJ, HS. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. SR and YC take responsibility that this study has been reported honestly, accurately, and transparently; that no important aspects of the study have been omitted, and that any discrepancies from the study as planned have been explained.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to disclose.

Supplementary material

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Supplementary material 1 (DOCX 45 kb)


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Occupational and Environmental Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Clinical Research Design and Evaluation, SAIHSTSungkyunkwan UniversitySeoulSouth Korea
  4. 4.Department of Radiology, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea
  5. 5.Department of Internal Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea
  6. 6.Department of Urology, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea
  7. 7.Department of Family Medicine, Kangbuk Samsung HospitalSungkyunkwan University School of MedicineSeoulSouth Korea

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