Solitary functioning kidney in children: clinical implications

Area of Science:

• Pediatric Nephrology
• Urology
• Medical Research

Background:

• Solitary functioning kidney (SFK) in children can lead to long-term complications not extensively documented.
• The impact of co-occurring congenital anomalies of the kidney and urinary tract (CAKUT) on renal function in SFK patients requires further investigation.

Purpose of the Study:

• To investigate the causes, clinical presentation, and associated CAKUT in children diagnosed with SFK.
• To assess the degree of renal damage and functional compromise in pediatric SFK cases.

Main Methods:

• A retrospective study included pediatric patients with SFK presenting between March 2014 and May 2016.
• Patients with malignancy were excluded to focus on non-cancerous conditions.

Main Results:

• Out of 20 SFK patients, 14 had primary SFK (agenesis or multicystic dysplastic kidney) and 6 had secondary SFK (due to obstructions or reflux).
• Eight patients (40%) had associated CAKUT, with 50% exhibiting reduced glomerular filtration rate (GFR), indicating compromised renal function. UTI and hypertension were also noted.
• While 20% were asymptomatic, 40% experienced urinary tract infections (UTI) and 30% had hypertension.

Conclusions:

• Pediatric SFK patients exhibit high morbidity, especially when associated with ipsilateral CAKUT.
• Long-term, periodic follow-up is vital for improving clinical outcomes in children with SFK and CAKUT.