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Tytuł:
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Renal function in children with a congenital solitary functioning kidney: A systematic review.
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Autorzy:
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Hutchinson KA; Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Halili L; Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Guerra A; Department of Chemical Engineering, McGill University, Montreal, Quebec, Canada.
Geier P; Department of Pediatrics, Division of Nephrology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Keays M; Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
Guerra L; Department of Surgery, Division of Urology, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: .
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Źródło:
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Journal of pediatric urology [J Pediatr Urol] 2021 Aug; Vol. 17 (4), pp. 556-565. Date of Electronic Publication: 2021 Mar 05.
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Typ publikacji:
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Journal Article; Systematic Review
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Język:
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English
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Imprint Name(s):
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Original Publication: Kidlington, Oxford, UK : Elsevier, c2005-
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MeSH Terms:
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Hypertension*/complications
Hypertension*/epidemiology
Multicystic Dysplastic Kidney*/complications
Solitary Kidney*/complications
Adolescent ; Child ; Humans ; Kidney/physiology ; Retrospective Studies
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Contributed Indexing:
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Keywords: Children; Congenital solitary kidney; Hypertension; MCDK; Proteinuria
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Entry Date(s):
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Date Created: 20210323 Date Completed: 20211014 Latest Revision: 20211014
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Update Code:
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20240105
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DOI:
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10.1016/j.jpurol.2021.03.001
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PMID:
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33752977
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Introduction: Abnormal renal development that results in lack of function or development of one of two kidneys is known as congenital solitary functioning kidney (CSFK). Two well characterized sub-categories of CFSK are unilateral renal agenesis (URA) and multicystic dysplastic kidney (MCDK). This systematic review sought to evaluate the change in renal function in children ≤18 years old with a CSFK as a result of URA or MCDK.
Methods: A literature search in MEDLINE and Embase was conducted (1946 to July 13, 2020). All relevant articles were retrieved and evaluated based on pre-selected criteria by two independent researchers. Data was then extracted from variables of interest and conflicts were resolved by a third researcher. The primary outcome was renal function, and the secondary outcomes were proteinuria and hypertension.
Results: Forty-five studies were included, of which 49% (n = 22) were retrospective and/or 58% (n = 26) were cohort studies. A combined total of 2148 and 885 patients were diagnosed with MCDK or URA, respectively. The proportion of children with worsened renal function at follow-up was found to be 8.4% (95% CI: 5.2%-13.4%). Among the studies reporting renal function as a group mean or median at follow-up, 84% (21/25) had a GFR/CrCl above 90 (mL/min/1.73 m 2 /ml/min). In terms of secondary outcomes, the proportion of children with proteinuria and hypertension was found to be 10.1% (95% CI: 6.9%-14.6%) and 7.4% (95% CI: 5.0%-10.9%), respectively.
Conclusion: The risk of developing proteinuria (10.1%), hypertension (7.4%), and/or worsened renal function (8.4%) for children with CFSK as a result of MCDK or URA is low. However, the level of evidence in the literature is weak. Further research is needed to identify the predisposing factors that may differentiate the small subset of children with CSFK at a higher risk of developing adverse renal outcomes.
Competing Interests: Conflict of interest None.
(Copyright © 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
