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Life with one kidney.

Michiel F Schreuder1

  • 1Department of Pediatric Nephrology, Amalia Children's Hospital, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands. michiel.schreuder@radboudumc.nl.

Pediatric Nephrology (Berlin, Germany)
|May 31, 2017
PubMed
Summary

Solitary functioning kidney (SFK) can lead to kidney injury before adulthood in over 50% of cases. Early screening and lifestyle changes are crucial for individuals with SFK to prevent long-term health issues.

Keywords:
ChildhoodGlomerular hyperfiltrationMulticystic dysplastic kidneySolitary functioning kidneyUnilateral renal agenesis

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Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Medical Genetics

Background:

  • Life with a solitary functioning kidney (SFK) may differ from having two kidneys.
  • The hyperfiltration hypothesis suggests SFK can cause glomerular damage, hypertension, albuminuria, and end-stage renal disease.
  • Contrary to the belief that SFK is benign, research shows over 50% of individuals experience renal injury before adulthood.

Purpose of the Study:

  • To highlight the risks associated with solitary functioning kidney (SFK).
  • To emphasize the need for early detection and management of renal injury in individuals with SFK.
  • To inform about potential genetic causes and associated anomalies in SFK cases.

Main Methods:

  • Review of existing research on solitary functioning kidney (SFK) and hyperfiltration.
  • Analysis of antenatal ultrasound screening data for unilateral renal agenesis.
  • Observation of renal hypertrophy as a potential indicator of nephron formation and risk reduction.

Main Results:

  • Over 50% of individuals with SFK develop renal injury before adulthood.
  • Up to 38% of unilateral renal agenesis cases are missed during antenatal screening.
  • Renal hypertrophy in SFK cases may indicate additional nephron formation and is linked to a reduced risk of injury.

Conclusions:

  • Individuals with SFK face a significant risk of renal injury, necessitating early and ongoing screening from infancy.
  • Avoiding obesity and excessive salt intake is recommended to mitigate hyperfiltration.
  • Early detection and treatment of conditions like hypertension and albuminuria are vital to prevent long-term health consequences and ensure optimal quality of life for individuals with SFK.