ESPN 53rd Annual Meeting

ESPN 2021


 
Kidney injury in a large cohort of children with solitary functioning kidney
SANDER GROEN IN T WOUD 1 NEL ROELEVELD 1 WOUT FEITZ 2 SOFIA STUDY GROUP 1 MICHIEL SCHREUDER 3 LOES VAN DER ZANDEN 1

1- RADBOUD UNIVERSITY MEDICAL CENTER, DEPARTMENT FOR HEALTH EVIDENCE, RADBOUD INSTITUTE FOR HEALTH SCIENCES, NIJMEGEN, THE NETHERLANDS
2- RADBOUDUMC AMALIA CHILDREN’S HOSPITAL, DEPARTMENT OF UROLOGY, RADBOUD INSTITUTE FOR MOLECULAR LIFE SCIENCES, NIJMEGEN, THE NETHERLANDS
3- RADBOUDUMC AMALIA CHILDREN’S HOSPITAL, DEPARTMENT OF PEDIATRIC NEPHROLOGY, RADBOUD INSTITUTE FOR MOLECULAR LIFE SCIENCES, NIJMEGEN, THE NETHERLANDS
 
Introduction:

 A solitary functioning kidney (SFK) in children is a condition resulting from a congenital anomaly of the kidney and urinary tract or acquired later in childhood. Patients with SFK are at higher risks of kidney injury, although it is unclear to which magnitude. Our objective was to investigate the risk of and risk factors for proteinuria, high blood pressure, a decreased glomerular filtration rate (GFR), or use of antihypertensive medication in children with SFK.

Material and methods:

 Children with congenital and acquired SFK were recruited in over 30 hospitals throughout the Netherlands. Information on risk factors for and signs of kidney injury were collected from electronic patient files. Kaplan-Meier curves were used to estimate survival without signs of kidney injury and Cox regression was used to evaluate risk factors.

Results:

 In total, 982 children provided informed consent and detailed clinical information was available from 898 (91%). Median follow-up duration was 9.7 years. Proteinuria was present in 118 (15%), high blood pressure in 184 (22%), a GFR below 60 ml/min/1.73m2 in 23 (3.2%), and antihypertensive medication was used by 90 (9.8%). In total, 319 children (36%) exhibited one or more signs of kidney injury and the median age at first sign of kidney injury was 4.4 year. Cumulative proportions of children with kidney injury were 20% at 5 years, 29% at 10 years, and 35% at 15 years of age. No differences in kidney injury rates were observed between boys and girls, left- or right-sided SFK, congenital or acquired SFK, and inclusion via secondary or tertiary hospital.

Conclusions:

 Data from this largest SFK cohort so far indicates that one third of patients with SFK has one or more signs of kidney injury at 15 years of age. Other risk factors will be investigated in our cohort to develop care strategies based on individual-patient risk profiles.