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Renal injury in children with a solitary functioning kidney--the KIMONO study

Rik Westland1, Michiel F Schreuder, Arend Bökenkamp

  • 1Department of Paediatric Nephrology, VU University Medical Centre, Amsterdam, The Netherlands. jae.vwijk@vumc.nl

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|March 24, 2011
PubMed

Insights

Children with a solitary functioning kidney (SFK) face early renal injury, including hypertension and albuminuria. This risk is higher with congenital anomalies of the kidney and urinary tract (CAKUT), necessitating close clinical follow-up.

Area of Science:

  • Pediatric Nephrology
  • Renal Physiology
  • Urology

Background:

  • Children with a solitary functioning kidney (SFK) are at increased risk for hypertension, albuminuria, and chronic kidney disease.
  • This risk may stem from glomerular hyperfiltration and congenital anomalies of the kidney and urinary tract (CAKUT).

Purpose of the Study:

  • To assess renal injury markers in children with SFK.
  • To investigate the impact of CAKUT on renal health in these children.
  • To evaluate the long-term risk of chronic kidney disease.

Main Methods:

  • Retrospective study of 206 children with SFK, categorized by origin (primary/congenital vs. secondary).
  • Stratification of data based on ipsilateral CAKUT presence.
  • Longitudinal modeling using generalized estimating equations for blood pressure, albuminuria, and glomerular filtration rate.

Main Results:

  • Renal injury (hypertension, albuminuria, or renoprotective medication) was found in 32% of children with SFK.
  • Children with ipsilateral CAKUT showed significantly higher rates of renal injury (48.3% vs. 24.6%).
  • Longitudinal models indicated a decline in glomerular filtration rate starting from puberty.

Conclusions:

  • Renal injury is prevalent in children with SFK even at a young age.
  • The presence of ipsilateral CAKUT exacerbates renal injury.
  • Children with SFK face an elevated risk of chronic kidney disease in adulthood, highlighting the need for ongoing clinical monitoring.
Abstract

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