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Author Topic: Growth and function in childhood of a normal solitary kidney from birth or from  (Read 3653 times)

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Offline Clark

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http://link.springer.com/article/10.1007/s00467-013-2623-4

Growth and function in childhood of a normal solitary kidney from birth or from early infancy
Ekaterini Siomou, Vasileios Giapros, Frederica Papadopoulou, Maria Pavlou, Andreas Fotopoulos, Antigoni Siamopoulou

Abstract
Background
Children with a solitary kidney (SK) have an increased long-term risk of hypertension, albuminuria and glomerulosclerosis. In this study, we assessed the early signs of impaired glomerular filtration in children with a SK from birth or from early infancy.
Methods
Renal growth and function at ages 4–15.5 years were studied in 38 children with SK and 40 matched control subjects in terms of accelerated growth.
Results
The systolic/diastolic blood pressure Z-scores (p = 0.01/<0.05) and the resistance index (RI) of the arcuate arteries (p = 0.05) were higher in the children with SK. Creatinine clearance and 24-h protein and albumin urinary excretion showed no difference. All but seven children with SK had 99mTc diethylene-triamine pentaacetic acid glomerular filtration rate values of >80 ml/min/1.73 m2. An independent positive correlation was found between length of the follow-up time and 24-h albumin urinary excretion (β = 0.54, p < 0.01). Accelerated postnatal growth was positively related with kidney volume (β = 0.35, p < 0.05).
Conclusions
Among our patient cohort, renal function was well preserved at ages 4–15.5 years in children who were born with a SK. However, both their higher blood pressure and RI and the correlation of 24-h albumin urinary excretion with length of follow-up time underline the need for monitoring to detect early signs of glomerular hyperfiltration and, if necessary, implement timely intervention. SK hypertrophy was found to be correlated with postnatal growth.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
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Offline Clark

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When you're told that folks born with one kidney "do just fine," remember that it ain't necessarily so.
Unrelated directed kidney donor in 2003, recipient and I both well.
620 time blood and platelet donor since 1976 and still giving!
Elected to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, and Ad Hoc Public Solicitation of Organ Donors Committees, 2005-2011
Proud grandpa!

 

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