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Solitary kidney and risk of chronic kidney disease

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Abstract

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.

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Authors and Affiliations

  1. Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Seolhye Kim, Yoosoo Chang, Hyun-Suk Jung, Kyung Eun Yun, Hocheol Shin & Seungho Ryu

  2. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, 04514, South Korea

    Yoosoo Chang & Seungho Ryu

  3. Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea

    Yoosoo Chang & Seungho Ryu

  4. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Young Rae Lee

  5. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Young Youl Hyun & Kyu-Beck Lee

  6. Department of Urology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Kwan Joong Joo

  7. Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Hocheol Shin

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  1. Seolhye Kim
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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.

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Correspondence to Yoosoo Chang or Seungho Ryu.

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Kim, S., Chang, Y., Lee, Y.R. et al. Solitary kidney and risk of chronic kidney disease. Eur J Epidemiol 34, 879–888 (2019). https://doi.org/10.1007/s10654-019-00520-7

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