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Correlation between hypertrophy and risk of hypertension in congenital solitary functioning kidney

Elisa Zambaiti1, Maria Sergio2, Fabio Baldanza2

  • 1Pediatric Urological Unit, Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", AOU Policlinico Paolo Giaccone, Via Giordano 3, 90127, Palermo, Italy. elisa.zambaiti@hotmail.it.

Pediatric Surgery International
|October 31, 2018
PubMed

Insights

Children with solitary functioning kidney (SFK) face higher risks of kidney hypertrophy and hypertension. Smaller or absent kidneys increase these risks compared to larger residual kidneys, regardless of treatment.

Area of Science:

  • Pediatric Nephrology
  • Hypertension Research
  • Renal Development

Background:

  • Solitary functioning kidney (SFK) is linked to potential complications like kidney hypertrophy, hypertension, and chronic kidney disease.
  • Understanding the impact of different congenital SFK types on blood pressure is crucial for early intervention.

Purpose of the Study:

  • To evaluate blood pressure (BP) profiles in children with congenital SFK.
  • To compare BP in children with unilateral kidney agenesis versus multicystic dysplastic kidney (MCDK).
  • To correlate BP with renal dimensions in affected and contralateral kidneys.

Main Methods:

  • Compared 40 MCDK patients (conservative vs. nephrectomy; early vs. late involution) and 10 unilateral agenesis patients.
  • Utilized ultrasound, scintigraphy, and office-ambulatory BP monitoring for patient evaluation.

Main Results:

  • Compensatory hypertrophy increased over time in most subjects.
  • Higher hypertrophy rates (83%-88%) and cumulative hypertension risk (p=0.03) were observed in agenesis and early MCDK involution groups compared to late involution.
  • 82% of children exhibited insufficient BP dipping, irrespective of SFK subtype.

Conclusions:

  • Small or absent dysplastic kidneys increase hypertrophy and hypertension risk compared to larger residual kidneys, irrespective of nephrectomy.
  • Ambulatory BP monitoring revealed absent dipping in most SFK patients, warranting further investigation even in asymptomatic cases.
Abstract

Keywords:
Congenital solitary functioning kidneyHypertensionMulticystic dysplastic kidneyRenal hypertrophy

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