Skip to main content
SpringerLink
Log in

Is microalbuminuria a risk factor for hypertension in children with solitary kidney?

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Background

The correlations between ambulatory blood pressure measurements (ABPM) and serum cystatin C (Cys C), serum creatinine (Cr), microalbumin (MA), and β2-microglobulin (β2-MG) levels in 24 h (24-h) urine were analyzed in children with solitary kidney (SK) and compared to healthy children.

Methods

Fifty children with normal functioning SK and 25 controls were studied. The ABPM, serum Cys C, serum Cr, MA, and β2-MG levels in 24-h urine were measured in all children. Clinical symptoms and signs, laboratory results, urinary ultrasonography, voiding cystourethrography, and Dimercaptosuccinic acid (DMSA) scintigraphy results were recorded in the SK group. Four patients with Wilms’ tumor and two with renal scarring were excluded from the study.

Results

The mean ages of the SK group and controls were 9.6 ± 3.6 and 9.3 ± 3.3 years, respectively. The serum Cys C and Cr levels, 24-h urinary β2-MG and MA levels were similar in both groups (p > 0.05). However, 24-h urinary MA excretion was higher in patients living with SK more than 5 years (p = 0.01). Standard deviation scores of ABPM parameters showed no significant correlation with serum Cr, serum Cys C, MA, and β2-MG in 24-h urine of both groups.

Conclusions

Children with SK have increased 24-h urinary MA excretion in the long term, and need prolonged follow-up to detect early deterioration of renal function and to prevent end-organ damage later in life.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Brenner BM, Lawler EV, Mackenzie HS (1996) The hyperfiltration theory: a paradigm shift in nephrology. Kidney Int 49:1774–1777

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  3. Fotino S (1989) The solitary kidney: a model of chronic hyperfiltration in humans. Am J Kidney Dis 13:88–98

    CAS  PubMed  Google Scholar 

  4. Zucchelli P, Cagnoli L, Casanova S, Donini U, Pasquali S (1983) Focal glomerulosclerosis in patients with unilateral nephrectomy. Kidney Int 24:649–655

    Article  CAS  PubMed  Google Scholar 

  5. Kiprov DD, Colvin RB, McCluskey RT (1982) Focal and segmental glomerulosclerosis and proteinuria associated with unilateral renal agenesis. Lab Invest 46:275–281

    CAS  PubMed  Google Scholar 

  6. Hakim RM, Goldszer RC, Brenner BM (1984) Hypertension and proteinuria: long-term sequelae of uninephrectomy in humans. Kidney Int 25:930–936

    Article  CAS  PubMed  Google Scholar 

  7. Saran S, Marshall SM, Madsen R, Keavey P, Tapson JS (1997) Long-term follow-up of kidney donors: a longitudinal study. Nephrol Dial Transplant 12:1615–1621

    Article  CAS  PubMed  Google Scholar 

  8. Novick AC, Gephardt G, Guz B, Steinmuller D, Tubbs RR (1991) Long-term follow-up after partial removal of a solitary kidney. N Engl J Med 325:1058–1062

    Article  CAS  PubMed  Google Scholar 

  9. Brenner BM, Meyer TW, Hostetter TH (1982) Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease. N Engl J Med 307:652–659

    Article  CAS  PubMed  Google Scholar 

  10. Brenner BM, Mackenzie HS (1997) Nephron mass as a risk factor for progression of renal disease. Kidney Int Suppl 63:S124–S127

    CAS  PubMed  Google Scholar 

  11. Amann K, Plank C, Dötsch J (2004) Low nephron number—a new cardiovascular risk factor in children? Pediatr Nephrol 19:1319–1323

    Article  PubMed  Google Scholar 

  12. Mei-Zahav 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

    Article  CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  14. 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

    Article  PubMed Central  PubMed  Google Scholar 

  15. Rosenbaum DM, Korngold E, TeeIe RL (1983) Sonographic Assessment of Renal Length in Normal Children. AJR Am J Roentgenol 142:467–469

    Article  Google Scholar 

  16. Neyzi O, Furman A, Bundak R, Gunoz H, Darendeliler F, Bas F (2006) Growth references for Turkish children aged 6 to 18 years. Acta Paediatr 95:1635–1641

    Article  PubMed  Google Scholar 

  17. Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A (1976) A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 58:259–263

    CAS  PubMed  Google Scholar 

  18. Soergel M, Kirschstein M, Busch C, Danne T, Gellermann J, Holl R, Krull F, Reichert H, Reusz GS, Rascher W (1997) Oscillometric twenty-four-hour ambulatory blood pressure values in healthy children and adolescents: a multicenter trial including 1141 subjects. J Pediatr 130:178–184

    Article  CAS  PubMed  Google Scholar 

  19. Wühl E, Witte K, Soergel M, Mehls O, Schaefer F; German Working Group on Pediatric Hypertension (2002) Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 20:1995–2007

    Article  Google Scholar 

  20. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents (2004) The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 114:555–576

    Article  Google Scholar 

  21. Solomon LR, Mallick NP, Lawler W (1985) Progressive renal failure in a remnant kidney. Br Med J 291:1610–1611

    Article  CAS  Google Scholar 

  22. Fine L (1986) The biology of renal hypertrophy. Kidney Int 29:619–634

    Article  CAS  PubMed  Google Scholar 

  23. Nagata M, Scharer K, Kriz W (1992) Glomerular damage after uninephrectomy in young rats. I. Hypertrophy and distortion of capillary architecture. Kidney Int 42:136–147

    Article  CAS  PubMed  Google Scholar 

  24. 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

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  26. Seeman T, Patzer L, John U, Dusek 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

    Article  PubMed  Google Scholar 

  27. Argueso LR, Ritchey ML, Boyle ET Jr, 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 

  28. Di Tullio MT, Casale F, Indolfi P, Polito C, Giuliano M, Martini A, Cimmaruta E, Morgera C, Cioce F, Greco N (1996) Compensatory hypertrophy and progressive renal damage in children nephrectomized for Wilms’ tumor. Med Pediatr Oncol 26:325–328

    Article  PubMed  Google Scholar 

  29. Anderson S, Meyer TW, Brenner BM (1985) The role of hemodynamic factors in the initiation and progression of renal disease. J Urol 133:363–368

    CAS  PubMed  Google Scholar 

  30. Watnick TJ, Jenkins RR, Rackoff P, Baumgarten A, Bia MJ (1988) Microalbuminuria and hypertension in long-term renal donors. Transplantation 45:59–65

    Article  CAS  PubMed  Google Scholar 

  31. Kasiske BL, Ma JZ, Louis TA, Swan SK (1995) Long-term effects of reduced renal mass in humans. Kidney Int 48:814–819

    Article  CAS  PubMed  Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  33. Regazzoni BM, Genton N, Pelet J, Drukker A, Guignard JP (1998) Long-term follow-up of renal functional reserve capacity after unilateral nephrectomy in childhood. J Urol 160:844–848

    Article  CAS  PubMed  Google Scholar 

  34. Seeman T, John U, Bláhová K, Vondrichová H, Janda J, Misselwitz J (2001) Ambulatory blood pressure monitoring in children with unilateral multicystic dysplastic kidney. Eur J Pediatr 160:78–83

    Article  CAS  PubMed  Google Scholar 

  35. Krzemień G, Roszkowska-Blaim M, Kostro I, Wojnar J, Karpińska M, Sekowska R (2006) Urological anomalies in children with renal agenesis or multicystic dysplastic kidney. J Appl Genet 47:171–176

    Article  PubMed  Google Scholar 

  36. Kaneyama K, Yamataka A, Satake S, Yanai T, Lane GJ, Kaneko K, Yamashiro Y, Miyano T (2004) Associated urologic anomalies in children with solitary kidney. J Pediatr Surg 39:85–87

    Article  PubMed  Google Scholar 

  37. 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 

  38. Larsson L, Aperia A, Wilton P (1980) Effect of normal development on compensatory renal growth. Kidney Int 18:29–35

    Article  CAS  PubMed  Google Scholar 

  39. Schmitz A, Christensen CK, Christensen T, Solling K (1989) No microalbuminuria or other adverse effects of long-standing hyperfiltration in humans with one kidney. Am J Kidney Dis 13:131–136

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Marmara University Medical Faculty, Istanbul, Turkey

    Ayoub Shirzai, Nurdan Yildiz, Nese Biyikli, Meryem Benzer & Harika Alpay

  2. Department of Biochemistry, Marmara University Medical Faculty, Istanbul, Turkey

    Seyfettin Ustunsoy

  3. Atasehir 48. Ada Mimoza2/6 D: 11, 34758, Istanbul, Turkey

    Nurdan Yildiz

Authors
  1. Ayoub Shirzai
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nurdan Yildiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nese Biyikli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seyfettin Ustunsoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Meryem Benzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Harika Alpay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nurdan Yildiz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shirzai, A., Yildiz, N., Biyikli, N. et al. Is microalbuminuria a risk factor for hypertension in children with solitary kidney?. Pediatr Nephrol 29, 283–288 (2014). https://doi.org/10.1007/s00467-013-2641-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-013-2641-2

Keywords

Search

Navigation