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Published on: July 18, 2025
Retrospective evaluation of children with unilateral renal agenesis
Tülin Güngör1, Fatma Yazılıtaş2, Evrim Kargın Çakıcı2
1Department of Pediatric Nephrology, Dr. Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey. tulingungor84@gmail.com.
Insights
Children with unilateral renal agenesis (URA) require lifelong monitoring for hypertension and kidney disease. Ambulatory blood pressure monitoring is crucial for detecting masked hypertension in these patients.
Area of Science:
- Pediatric Nephrology
- Renal Development
- Hypertension Research
Background:
- Unilateral renal agenesis (URA) is associated with risks of hypertension, proteinuria, and chronic kidney disease (CKD).
- Long-term outcomes and clinical features in pediatric URA patients require further investigation.
Purpose of the Study:
- To evaluate the long-term prognosis of children diagnosed with URA.
- To characterize the clinical features and identify risk factors in pediatric URA patients.
Main Methods:
- Retrospective analysis of 171 pediatric patients with URA followed for at least 1 year.
- Comparison with 121 age, gender, and BMI-matched healthy controls.
- Assessment of proteinuria, hyperfiltration, CKD, and hypertension using ambulatory blood pressure monitoring (ABPM).
Main Results:
- URA incidence was higher in males (65.4%).
- 2.3% had proteinuria, 15.2% hyperfiltration, and 2.9% CKD.
- Hypertension detected in 10.5% of URA patients, with 10 cases of masked hypertension; diastolic blood pressure was significantly higher than controls.
Conclusions:
- Pediatric URA patients need lifelong monitoring for urine protein, blood pressure, and kidney function.
- ABPM is essential for detecting masked hypertension and non-dipper phenomenon in pediatric URA.
- Co-existing urinary system anomalies increase the risk of hypertension and CKD.
Background:
Children born with unilateral renal agenesis (URA) are thought to have a risk of developing hypertension, proteinuria, and progressive chronic kidney disease (CKD). The present study aimed to evaluate the long-term prognosis and clinical characteristics of children with URA.
Methods:
The study included 171 patients aged < 18 years diagnosed as URA who were followed-up for ≥ 1 year and 121 healthy controls matched for age, gender, and BMI.
Results:
Median age at diagnosis was 2 years (IQR: 1 month-16 years) and the incidence of URA in males (65.4%) was higher than in females. Among the patients, 21 (12.2%) had other urinary system anomalies. It was noted that 2.3% of the patients had proteinuria, 15.2% had hyperfiltration, and 2.9% had CKD. Hypertension based on ambulatory blood pressure monitoring (ABPM) was diagnosed in 18 (10.5%) of the patients, of whom 10 had masked hypertension. Diastolic blood pressure in the URA patients was significantly higher than in the healthy controls. The incidence of hypertension and CKD was significantly higher in the patients with other urinary system anomalies.
Conclusions:
Patients with a single functional kidney should be periodically evaluated throughout their lifetime for urine protein, blood pressure, and kidney functions. The most remarkable finding of this study is the importance of the use of ABPM for evaluating blood pressure in pediatric URA patients, especially for the detection of masked hypertension and the non-dipper phenomenon, which cannot be achieved with office blood pressure measurement.
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