Congenital solitary functioning kidney represents major risk factor for renal injury
A recent study reveals a 3.9-percent prevalence of renal damage among patients enrolled early with congenital solitary functioning kidney with a prenatal diagnosis, excluding those with neonatal onset of renal damage. Furthermore, the major predictor among congenital anomalies of the kidney and urinary tract is congenital solitary functioning kidney.
Researchers retrospectively assessed 322 patients with congenital solitary functioning kidney according to the following inclusion criteria: 1) prenatal diagnosis of solitary kidney; 2) first evaluation at 1 to 3 months of life with confirmation of congenital solitary functioning kidney and evaluation of possible associated congenital anomalies of the kidney and urinary tract by abdominal ultrasound, renal scintigraphy and cystography; and 3) absence of any condition potentially affecting renal function in the neonatal period as well as absence of renal injury at enrolment (1 to 3 months of life) confirmed by a normal estimated glomerular filtration rate, lack of proteinuria and hypertension.
A total of 306 patients were followed-up (median 7.2 years; range, 1 to 23), of whom 12 (3.9 percent) had one or more signs of renal injury. Considering the entire population, 93.7 percent of patients were free from renal injury at age 17 years compared with 81.3 and 95.9 percent for those with and without congenital anomalies of the kidney and urinary tract of congenital solitary functioning kidney (p<0.001), respectively.
Among the congenital anomalies of the kidney and urinary tract, congenital solitary functioning kidney was the strongest predictor of renal injury (hazard ratio, 8.75; 95 percent CI, 2.77 to 27.65).