title: The impact of small kidneys.
abstract: BACKGROUND
  Small kidneys due to renal hypodysplasia (RHD) result from a decrease in nephron number. The objectives of this study were to identify clinical variables that determine long-term renal outcome in children with RHD and to define the role of kidney size as a predictor of developing end-stage renal disease (ESRD).
  
  
  METHODS
  This was a single-center retrospective cohort analysis. The primary outcome was development of ESRD. We identified 202 RHD cases, with 25 (12%) reaching ESRD at mean age of 8.9 (±6.6) years.
  
  
  RESULTS
  Children with RHD with a known genetic syndrome had the smallest kidneys while those with posterior urethral valves (PUV) had the largest kidneys at diagnosis. Cases with bilateral RHD were most likely to develop ESRD. Younger gestational age (OR 0.8, CI 0.69-0.99, p = 0.05), smaller kidney size at diagnosis (OR 0.13, CI 0.03-0.47, p = 0.002), lower best-estimated glomerular filtration rate (eGFR) (OR 0.74, CI 0.58-0.93, p = 0.01), proteinuria (OR 1.03, CI 1.01-1.05, p < 0.001) and high blood pressure (OR 1.02, CI 1.01-1.04, p = 0.01) were associated with development of ESRD, while kidney size at diagnosis was independently associated with ESRD (HR 0.03, CI 0.01-0.72, p = 0.043).
  
  
  CONCLUSIONS
  In children with RHD, kidney size at diagnosis predicts the likelihood of developing ESRD.
authors: Department of Pediatrics, British Columbia Children's Hospital, Vancouver, BC, Canada, dmatsell@cw.bc.ca.
authors: Douglas G
authors: DG
authors: Matsell
authors: Dan
authors: D
authors: Cojocaru
authors: Eli W
authors: EW
authors: Matsell
authors: Allison A
authors: AA
authors: Eddy
mesh_terms: D000293:Adolescent; D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000002:abnormalities / Q000473:pathology / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009929:Organ Size; D063868:Patient Outcome Assessment; D011379:Prognosis; D011507:Proteinuria / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D014564:Urogenital Abnormalities / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology
chemical_list: D003404:Creatinine