Outcomes of prenatally diagnosed solitary functioning kidney during early life

Area of Science:

• Pediatric Nephrology
• Congenital Abnormalities
• Renal Physiology

Background:

• Congenital solitary functioning kidney (SFK) is a condition where an individual is born with only one kidney that functions.
• Understanding the long-term outcomes of SFK is crucial for pediatric healthcare.
• Early identification and monitoring are key to managing potential complications.

Purpose of the Study:

• To evaluate the clinical outcomes and renal function in children with congenital solitary functioning kidney (SFK) during early childhood.
• To assess the role of compensatory hypertrophy as a prognostic indicator for renal function in SFK.
• To identify any potential renal damage or complications associated with SFK in this age group.

Main Methods:

• A retrospective study involving 32 children diagnosed with SFK prenatally.
• Follow-up duration ranged from 1 to 11.5 years.
• Assessment included serial sonographic evaluations of kidney size and postnatal monitoring of glomerular filtration rate, hyperfiltration, hypertension, and proteinuria.

Main Results:

• Compensatory hypertrophy of the SFK was observed in 45% of fetal evaluations and 85% by postnatal follow-up.
• Glomerular filtration rate was below normal in 44.4% of infants under 1 year, decreasing to 0% in older children.
• Hyperfiltration increased with age (18.5% at <1 year to 82.6% at >3 years), while hypertension (35% at 1-3 years) and proteinuria were not observed in older children.

Conclusions:

• Congenital solitary functioning kidney (SFK) is generally associated with minimal renal damage in infancy and childhood.
• Compensatory enlargement of the SFK begins in the fetal stage.
• In utero compensatory growth of the SFK may serve as a positive prognostic indicator for normal renal function post-birth.