ESPN 53rd Annual Meeting

ESPN 2021


 
Renal Outcome Of Children With Solitary Functioning Kidney
RABIA GUNDOGAN 1 ELIF COMAK 2 MUSTAFA KOYUN 2 AYGÜL KERNAK ELMALI 3 GULSAH KAYA AKSOY 2 SEMA AKMAN 2

1- AKDENIZ UNIVERSITY MEDICAL FACULTY, PEDIATRICS, ANTALYA, TURKEY
2- AKDENIZ UNIVERSITY MEDICAL FACULTY, PEDIATRIC NEPHROLOGY, ANTALYA, TURKEY
3- AKDENIZ UNIVERSITY MEDICAL FACULTY, RADIOLOGY, ANTALYA, TURKEY
 
Introduction:

Children with a Solitary Functioning Kidney (SFK) have an increased risk of developing hypertension, albuminuria and chronic kidney disease. The aim of this study was to evaluate the clinical characteristics and renal outcome in children with SFK

Material and methods:

The medical records of children with SFK who had followed at our clinic were reviewed retrospectively. Renal injury was defined as hypertension, proteinuria, an impaired glomerular filtration rate, and/or the use of renoprotective medication.

Results:

A total of 206 children, 125 boys (60.7%), median age at last visit of 9.36±5.27 years, median follow-up of 56.14±46.52 months were included in the study. Among 206 children with SFK, 121 (58.73%) presented with unilateral renal agenesis, 53 (25.72%) multicystic dysplastic kidney and 32 (15.53%) children had underwent nephrectomy secondary to congenital anomalies of the kidney and urinary tract (CAKUT). 81 patients had renal injury (44.5%), 25 patients GFR <60 ml/min/1.73 m2 (14.4%), 32 (15.5%) had hypertension, 22 had (11.5%) hyperfiltration, 22(10.7%) had proteinuria, 49(23.8%) had use of renoprotective drugs, and 143 patients(69.8%) had compensatory hypertrophy; anemia was detected in 32.5%. In univariate analysis, male gender, presence of additional urological anomaly, premature birth, presence of urinary tract infection history, presence of hyperuricemia, birth weight < 2500 g were found to be associated with renal injury. However, in multivariate analysis, only hyperuricemia and prematurity were associated with renal injury [(OR:4.83, CI:1.75-13.34) and (OR:3.026, CI:1.103-8.303) repectively]. In study group, a statistically significant decrease was observed between creatinine and eGFR values of 6th month, 1st year and 5th year (p< 0.001).

Conclusions:

Our findings demonstrate that renal injury is present in children with SFK at early age. Kidney functions of these patients start to deteriorate over years starting from young age. Kidney protective approaches should be taken at follow-up of these children.