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[Solitary kidney: Management and outcome].
A Godron-Dubrasquet1, C Didailler1, J Harambat1
1Unité de néphrologie pédiatrique, hôpital Pellegrin-Enfants, CHU de Bordeaux, place Amélie-Raba-Leon, 33076 Bordeaux cedex, France.
Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|September 24, 2017
Summary
Solitary functioning kidneys increase the risk of chronic kidney disease (CKD) due to reduced nephron number and hyperfiltration. Lifelong monitoring and early nephroprotective measures are crucial for managing hypertension and preserving kidney function.
Area of Science:
- Nephrology
- Pediatric Nephrology
- Urology
Background:
- Solitary functioning kidneys, whether congenital or acquired, are linked to congenital anomalies of the kidney and urinary tract (CAKUT).
- These conditions predispose individuals to an elevated risk of developing chronic kidney disease (CKD).
Purpose of the Study:
- To highlight the risks associated with solitary functioning kidneys.
- To emphasize the importance of long-term monitoring and early intervention for preventing kidney damage.
Main Methods:
- Review of existing literature on solitary functioning kidneys and associated risks.
- Analysis of the pathophysiological mechanisms leading to chronic kidney disease in these patients.
- Discussion of recommended monitoring strategies and nephroprotective measures.
Main Results:
- Solitary kidneys lead to compensatory glomerular hyperfiltration, potentially causing glomerulosclerosis.
- Hypertension, proteinuria, and reduced glomerular filtration rate (GFR) affect 20-30% of patients during childhood, particularly those with CAKUT.
- Long-term complications include hypertension, proteinuria, and progressive GFR decline.
Conclusions:
- Solitary functioning kidneys necessitate lifelong monitoring for early detection of renal injury.
- Individualized follow-up plans are essential, adapting frequency and methods to CKD risk.
- Timely implementation of nephroprotective strategies is critical for preserving kidney function and preventing disease progression.
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