Abstract
In patients with a single functioning kidney, renal function was assessed at regular intervals over a period of 10 years. Serum creatinine, glomerular filtration rate (GFR), blood pressure, and urinary protein–creatinine ratio were assessed at the age of 2, 5 and 10 years. Between January 1980 and December 2005, 99 such patients were diagnosed in the first year of life. They were divided into three groups: A, patients with multicystic kidney disease and a normal contralateral kidney (n = 36); B, patients with a normal solitary kidney without uropathy (n = 20); and C, patients with obstructive uropathy and one nonfunctioning kidney (n = 43). Serum creatinine levels increased significantly with increasing age in every group. In group C, serum creatinine was significantly elevated compared with group A in all age categories (p = 0.043, p = 0.019, p = 0.001 respectively). Median figures of GFR remained within normal limits over the 10-year period. GFR was significantly lower in group C compared with group A (p = 0.001, p = 0.009, p = 0.019 respectively) and B in all age categories (p = 0.013, p = 0.002, p = 0.016 respectively). There were no changes in blood pressure over time and no differences among the three groups were observed. At the age of 10 years, the patients in group C had a significantly higher median urinary protein–creatinine ratio (p = 0.022) than those in groups A and B. There was also an increasing level of proteinuria with increasing age in group C (p = 0.002). In conclusion, renal function was stable over time in all patients, but children with obstructive uropathy have a lower median GFR and higher serum creatinine level for the whole study period. Hypertension was exceptionally observed in group C, with obstructive uropathy, as was an elevated urinary protein–creatinine ratio.
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Abbreviations
- ABPM:
-
ambulatory blood pressure measurement
- GFR:
-
glomerular filtration rate
- MCKD:
-
multicystic kidney disease
- Up/c:
-
urinary protein–creatinine ratio
- UPJO:
-
ureteropelvic junction obstruction
- UVJO:
-
ureterovesical junction obstruction
- VUR:
-
vesico-ureteral reflux
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Vu, KH., Van Dyck, M., Daniels, H. et al. Renal outcome of children with one functioning kidney from birth. A study of 99 patients and a review of the literature. Eur J Pediatr 167, 885–890 (2008). https://doi.org/10.1007/s00431-007-0612-y
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DOI: https://doi.org/10.1007/s00431-007-0612-y