title: Renal outcome of children with one functioning kidney from birth. A study of 99 patients and a review of the literature.
abstract: In patients with a single functioning kidney, renal function was assessed at regular intervals over a period of 10 years. Serum creatinine, glomerular filtration rate (GFR), blood pressure, and urinary protein-creatinine ratio were assessed at the age of 2, 5 and 10 years. Between January 1980 and December 2005, 99 such patients were diagnosed in the first year of life. They were divided into three groups: A, patients with multicystic kidney disease and a normal contralateral kidney (n = 36); B, patients with a normal solitary kidney without uropathy (n = 20); and C, patients with obstructive uropathy and one nonfunctioning kidney (n = 43). Serum creatinine levels increased significantly with increasing age in every group. In group C, serum creatinine was significantly elevated compared with group A in all age categories (p = 0.043, p = 0.019, p = 0.001 respectively). Median figures of GFR remained within normal limits over the 10-year period. GFR was significantly lower in group C compared with group A (p = 0.001, p = 0.009, p = 0.019 respectively) and B in all age categories (p = 0.013, p = 0.002, p = 0.016 respectively). There were no changes in blood pressure over time and no differences among the three groups were observed. At the age of 10 years, the patients in group C had a significantly higher median urinary protein-creatinine ratio (p = 0.022) than those in groups A and B. There was also an increasing level of proteinuria with increasing age in group C (p = 0.002). In conclusion, renal function was stable over time in all patients, but children with obstructive uropathy have a lower median GFR and higher serum creatinine level for the whole study period. Hypertension was exceptionally observed in group C, with obstructive uropathy, as was an elevated urinary protein-creatinine ratio.
authors.affiliation: Pediatric Nephrology, University Hospital Leuven, Herestraat 49, 3000, Leuven, Belgium.
authors.forename: Kieu-Hanh
authors.initials: KH
authors.lastname: Vu
authors.forename: Maria
authors.initials: M
authors.lastname: Van Dyck
authors.forename: Hans
authors.initials: H
authors.lastname: Daniels
authors.forename: Willem
authors.initials: W
authors.lastname: Proesmans
mesh_terms: D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000503:physiopathology*; D007674:Kidney Diseases / Q000151:congenital / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D021782:Multicystic Dysplastic Kidney / Q000503:physiopathology; D011507:Proteinuria / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D003404:Creatinine