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Development and autoregulation of kidney function in children: a retrospective study using 99mTc-MAG3 renography

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Abstract

Background

Both the development of kidney function in healthy children and autoregulation ability of kidney function in patients with asymmetric kidneys are important in clinical diagnosis and treatment of kidney-related diseases, but there are however only limited studies. This study aimed to investigate development of kidney function in normal children with healthy symmetric kidneys and autoregulation of the healthy kidney compensating the functional loss of a diseased one in children with asymmetric kidneys.

Methods

Two hundred thirty-seven children (156 male, 81 female) from 0 to 20y (average 4.6y ± 5.1) undergoing 99mTc-MAG3 renography were included, comprising 134 with healthy symmetrically functioning kidneys and 103 with asymmetric kidneys. Clearance was calculated from kidney uptakes at 1–2 min. A developmental model between MAG3 clearance (CL) and patient age in normal group was identified (CL = 84.39Age0.395 ml/min, r = 0.957, p < 0.001). The clearance autoregulation rate in abnormal group with asymmetric kidneys was defined as the ratio of the measured MAG3 clearance and the normal value predicted from the renal developmental model of normal group.

Results

No significant difference of MAG3 clearance (p = 0.723) was found between independent abnormal group and normal group. The autoregulation rate of kidney clearance in abnormal group was 94.2% on average, and no significant differences were found between two age groups (p = 0.49), male and female (p = 0.39), and left kidney and right kidney (p = 0.92) but two different grades of asymmetric kidneys (p = 0.02).

Conclusions

The healthy kidney of two asymmetric kidneys can automatically regulate total kidney function up to 94% of two symmetric kidneys in normal children.

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Acknowledgements

The work of Dr. X Xu and X Cao was supported by the NIH R01LM012434.

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Authors and Affiliations

  1. Department of Radiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    Xinhua Cao, Laura A. Drubach, Neha Kwatra, Frederic H. Fahey & Stephan D. Voss

  2. Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Xiaoyin Xu, S. Ted Treves & Min Zhang

  3. Department of Urology, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    David A. Diamond

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  1. Xinhua Cao
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Correspondence to Xinhua Cao.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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For this type of retrospective study, the requirement for informed consent was waived by the hospital institutional review board.

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Cao, X., Xu, X., Treves, S.T. et al. Development and autoregulation of kidney function in children: a retrospective study using 99mTc-MAG3 renography. Pediatr Nephrol 37, 2157–2166 (2022). https://doi.org/10.1007/s00467-022-05446-z

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