Related Experiment Videos
Kidney function in adults born with unilateral renal agenesis or nephrectomized in childhood
I Wikstad1, G Celsi, L Larsson
1Department of Radiology, St. Göran's Children's Hospital, Karolinska Institute, Stockholm, Sweden.
Insights
Adults with a single kidney since childhood have a good long-term prognosis. However, a slow decline in glomerular filtration rate (GFR) and increased albumin excretion suggest a moderate risk for future kidney damage.
Area of Science:
- Nephrology
- Pediatric Urology
- Longitudinal Studies
Background:
- Unilateral renal agenesis and childhood nephrectomy result in a single functioning kidney.
- Long-term outcomes for individuals with a single kidney are not fully understood.
- Assessing renal function and potential damage over time is crucial.
Purpose of the Study:
- To evaluate the long-term prognosis of adult patients with a single kidney since childhood.
- To identify changes in renal function and markers of kidney damage over extended follow-up periods.
- To determine the risk factors for premature renal damage in this population.
Main Methods:
- Longitudinal follow-up of 36 adult patients (aged 7-47 years) with a single kidney.
- Comparison of renal function (GFR, CPAH) and albuminuria with 23 age-matched controls.
- Monitoring of kidney size, arterial blood pressure, and renal insufficiency over 7-40 years.
Main Results:
- Single kidneys were larger with higher initial GFR and CPAH compared to controls.
- A slow but significant decline in GFR and CPAH was observed over the follow-up period.
- Microalbuminuria occurred in 47% of patients, increasing with longer follow-up; no renal insufficiency or hypertension was noted.
Conclusions:
- Adults with a single kidney since childhood generally have a good long-term prognosis.
- Late-onset decline in GFR and increased albuminuria indicate a potential risk for moderate, premature renal damage.
- Regular monitoring for renal function decline and albuminuria is recommended for this patient group.
Abstract:
We have evaluated the long-term prognosis in an unselected group of adult patients either uni-nephrectomized in childhood because of hydronephrosis or born with unilateral renal agenesis. Thirty-six patients aged 7-47 years were followed for 7-40 years. In 23 control subjects aged 20-47 years the glomerular filtration rate (GFR) and the p-aminohippuric acid clearance (CPAH) did not change significantly with age. In patients with a single kidney the size of that kidney was larger and GFR and CPAH were higher than single kidney values in control subjects. However, in patients with a single kidney since childhood the GFR and the CPAH declined slowly but significantly during the follow-up period. Significant microalbuminuria occurred in 47% of the patients with a single kidney and was more frequent with a longer follow-up period. No patient had renal insufficiency or a marked increase in arterial blood pressure. We conclude that in patients with a single kidney since childhood the long-term prognosis is good, but the late decrease in GFR and increase in albumin excretion may indicate a moderate risk for premature renal damage.