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Evolution of blood pressure in children with congenital and acquired solitary functioning kidney
Riccardo Lubrano1, Isotta Gentile2, Raffaele Falsaperla3
1Pediatric Department, Pediatric Nephrology Unit, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. riccardo.lubrano@uniroma1.it.
Insights
Children with a solitary functioning kidney maintain stable renal function over 14 years. However, careful monitoring for elevated blood pressure is crucial, especially in those with acquired solitary kidneys.
Area of Science:
- Pediatric Nephrology
- Renal Physiology
- Hypertension Research
Background:
- Solitary functioning kidney in children presents unique challenges.
- Understanding differences in outcomes between congenital and acquired solitary kidneys is critical.
Purpose of the Study:
- To compare the evolution of blood pressure and renal function in children with congenital versus acquired solitary functioning kidneys.
- To identify potential differences in disease progression and risk factors.
Main Methods:
- Retrospective study of 55 children with solitary functioning kidneys (37 congenital, 18 acquired).
- Analysis of glomerular filtration rate, proteinuria, and blood pressure over a 14-year follow-up period (1997-2015).
Main Results:
- Glomerular filtration rate and proteinuria showed no significant changes over 14 years.
- A significant increase in arterial hypertension was observed, particularly in children with acquired solitary kidneys (12% to 52.9%).
- Children with congenital solitary kidneys showed a trend towards pre-hypertension (7.9% to 44.7%).
Conclusions:
- Renal function remains stable in children with solitary functioning kidneys over 14 years.
- Close monitoring for elevated blood pressure is essential in this patient population.
- Acquired solitary kidneys may present a higher risk for developing hypertension compared to congenital solitary kidneys.
Background:
It is not yet clear if blood pressure and renal function changes evolve differently in children with a congenital or acquired solitary functioning kidney. This study aims to assess if there are any differences between these two types of solitary kidney patients.
Methods:
Current research is a retrospective study assessing the evolution of glomerular filtration rate, proteinuria, and blood pressure in clinical records of 55 children with a solitary functioning kidney (37 congenital and 18 acquired). We used the medical records of children who had been assisted, in our unit of pediatric nephrology, for a period of 14 years (168 months), from the time of diagnosis, between January/1997 and December/2015.
Results:
During the study period, glomerular filtration rate (T0 128.89 ± 32.24 vs T14 118.51 ± 34.45 ml/min/1.73 m2, p NS) and proteinuria (T0 85.14 ± 83.13 vs T14 159.03 ± 234.66 mg/m2/die, p NS) demonstrated no significant change. However, after 14 years of follow-up 76.4% of patients had increased levels of arterial hypertension with values over the 90th percentile for gender, age, and height. Specifically, children with an acquired solitary functioning kidney mainly developed hypertension [T0 2/17 (12%) vs T14 9/17 (52.9%) p < 0.025], whereas children with a congenital solitary functioning kidney mainly developed pre-hypertension [T0 3/38 (7.9%) vs T14 17/38 (44.7%) p < 0.0005].
Conclusions:
The renal function of children with solitary functioning kidneys remains stable during a follow-up of 14 years. However, these children should be carefully monitored for their tendency to develop arterial blood pressure greater than the 90th percentile for gender, age, and height.
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