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Retrospective evaluation of children with unilateral renal agenesis

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Abstract

Background

Children born with unilateral renal agenesis (URA) are thought to have a risk of developing hypertension, proteinuria, and progressive chronic kidney disease (CKD). The present study aimed to evaluate the long-term prognosis and clinical characteristics of children with URA.

Methods

The study included 171 patients aged < 18 years diagnosed as URA who were followed-up for ≥ 1 year and 121 healthy controls matched for age, gender, and BMI.

Results

Median age at diagnosis was 2 years (IQR: 1 month–16 years) and the incidence of URA in males (65.4%) was higher than in females. Among the patients, 21 (12.2%) had other urinary system anomalies. It was noted that 2.3% of the patients had proteinuria, 15.2% had hyperfiltration, and 2.9% had CKD. Hypertension based on ambulatory blood pressure monitoring (ABPM) was diagnosed in 18 (10.5%) of the patients, of whom 10 had masked hypertension. Diastolic blood pressure in the URA patients was significantly higher than in the healthy controls. The incidence of hypertension and CKD was significantly higher in the patients with other urinary system anomalies.

Conclusions

Patients with a single functional kidney should be periodically evaluated throughout their lifetime for urine protein, blood pressure, and kidney functions. The most remarkable finding of this study is the importance of the use of ABPM for evaluating blood pressure in pediatric URA patients, especially for the detection of masked hypertension and the non-dipper phenomenon, which cannot be achieved with office blood pressure measurement.

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Data availability

The complete data can be obtained from the corresponding author on request.

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Acknowledgements

The authors gratefully acknowledge Mr. Scott Evans for English language editing.

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey

    Tülin Güngör, Fatma Yazılıtaş, Evrim Kargın Çakıcı, Evra Çelikkaya, Deniz Karakaya & Mehmet Bülbül

  2. Department of Radiology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey

    Ayşe Seçil Ekşioğlu

  3. Department of Pediatric Rheumatology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey

    Esra Bağlan & Mehmet Bülbül

Authors
  1. Tülin Güngör
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  2. Fatma Yazılıtaş
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  8. Mehmet Bülbül
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Contributions

Study concept and design: Tülin Güngör, Fatma Yazılıtaş, Mehmet Bülbül

Analysis and interpretation of data: Tülin Güngör, Evrim Kargın Çakıcı, Ayşe Seçil Ekşioğlu

Drafting of the manuscript: Tülin Güngör, Evra Çelikkaya, Deniz Karakaya

Critical revision of the manuscript for important intellectual content: Tülin Güngör, Fatma Yazılıtaş, Esra Bağlan

Corresponding author

Correspondence to Tülin Güngör.

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Ethics approval

The study protocol was approved by the Dr. Sami Ulus Training and Research Hospital Ethics Committee.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no conflict of interest.

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Güngör, T., Yazılıtaş, F., Çakıcı, E.K. et al. Retrospective evaluation of children with unilateral renal agenesis. Pediatr Nephrol 36, 2847–2855 (2021). https://doi.org/10.1007/s00467-021-05027-6

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  • DOI: https://doi.org/10.1007/s00467-021-05027-6

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