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Risk factors for renal injury in children with a solitary functioning kidney

Rik Westland1, Roel A J Kurvers, Joanna A E van Wijk

  • 1Department of Pediatric Nephrology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, Netherlands. r.westland@vumc.nl

Pediatrics
|January 16, 2013
PubMed

Insights

Children with a solitary functioning kidney face risks of renal injury, including hypertension and kidney disease. Early clinical follow-up from birth is crucial for monitoring and managing these risks.

Area of Science:

  • Pediatric Nephrology
  • Renal Physiology
  • Congenital Anomalies

Background:

  • The hyperfiltration hypothesis suggests solitary functioning kidney (SFK) increases risks of hypertension, proteinuria, and chronic kidney disease.
  • Understanding the onset and risk factors for renal injury in children with SFK is critical for proactive management.

Purpose of the Study:

  • To determine the age of presentation for renal injury in children with SFK.
  • To identify independent risk factors associated with renal injury in this population.

Main Methods:

  • A cohort of 407 patients with SFK was evaluated for renal injury markers (hypertension, proteinuria, impaired GFR, renoprotective medication).
  • Patients were stratified by SFK type and presence of congenital anomalies of the kidney and urinary tract (CAKUT).
  • Kaplan-Meier analysis and logistic regression models were used to assess renal injury development and risk factors.

Main Results:

  • Renal injury was observed in 37% of all children studied.
  • Ipsilateral CAKUT (OR 1.66) and increasing age (OR 1.09) were significant risk factors for renal injury.
  • A shorter time to renal injury was noted in patients with ipsilateral CAKUT (12.8 years) compared to the overall median (14.8 years).

Conclusions:

  • Independent risk factors for renal injury in children with SFK have been identified.
  • The high incidence of renal injury underscores the necessity for lifelong clinical surveillance starting from birth.
Abstract

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