Is microalbuminuria a risk factor for hypertension in children with solitary kidney?
BACKGROUND
The correlations between ambulatory blood pressure measurements (ABPM) and serum cystatin C (Cys C), serum creatinine (Cr), microalbumin (MA), and β2-microglobulin (β2-MG) levels in 24 h (24-h) urine were analyzed in children with solitary kidney (SK) and compared to healthy children.


METHODS
Fifty children with normal functioning SK and 25 controls were studied. The ABPM, serum Cys C, serum Cr, MA, and β2-MG levels in 24-h urine were measured in all children. Clinical symptoms and signs, laboratory results, urinary ultrasonography, voiding cystourethrography, and Dimercaptosuccinic acid (DMSA) scintigraphy results were recorded in the SK group. Four patients with Wilms' tumor and two with renal scarring were excluded from the study.


RESULTS
The mean ages of the SK group and controls were 9.6 ± 3.6 and 9.3 ± 3.3 years, respectively. The serum Cys C and Cr levels, 24-h urinary β2-MG and MA levels were similar in both groups (p > 0.05). However, 24-h urinary MA excretion was higher in patients living with SK more than 5 years (p = 0.01). Standard deviation scores of ABPM parameters showed no significant correlation with serum Cr, serum Cys C, MA, and β2-MG in 24-h urine of both groups.


CONCLUSIONS
Children with SK have increased 24-h urinary MA excretion in the long term, and need prolonged follow-up to detect early deterioration of renal function and to prevent end-organ damage later in life.
Department of Pediatric Nephrology, Marmara University Medical Faculty, Istanbul, Turkey.
Ayoub
A
Shirzai
Nurdan
N
Yildiz
Nese
N
Biyikli
Seyfettin
S
Ustunsoy
Meryem
M
Benzer
Harika
H
Alpay
D000293:Adolescent; D000419:Albuminuria / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D007668:Kidney / Q000002:abnormalities* / Q000503:physiopathology*; D007674:Kidney Diseases / Q000150:complications / Q000151:congenital*; D007677:Kidney Function Tests; D008297:Male; D021782:Multicystic Dysplastic Kidney / Q000150:complications*; D009392:Nephrectomy / Q000009:adverse effects*; D012307:Risk Factors