Outcomes of a Cohort of Prenatally Diagnosed and Early Enrolled Patients with Congenital Solitary Functioning Kidney
2017; Lippincott Williams & Wilkins; Volume: 198; Issue: 5 Linguagem: Inglês
10.1016/j.juro.2017.05.076
ISSN1527-3792
AutoresPierluigi Marzuillo, Stefano Guarino, Anna Grandone, Allegra Di Somma, Nicoletta Della Vecchia, Tiziana Esposito, Giulia Macchini, Rosaria Marotta, Andrea Apicella, Mario Diplomatico, Pier Francesco Rambaldi, Laura Perrone, Emanuele Miraglia del Giudice, Angela La Manna, Cesare Polito,
Tópico(s)Neonatal Health and Biochemistry
ResumoNo AccessJournal of UrologyPediatric Urology1 Nov 2017Outcomes of a Cohort of Prenatally Diagnosed and Early Enrolled Patients with Congenital Solitary Functioning Kidney Pierluigi Marzuillo, Stefano Guarino, Anna Grandone, Allegra Di Somma, Nicoletta Della Vecchia, Tiziana Esposito, Giulia Macchini, Rosaria Marotta, Andrea Apicella, Mario Diplomatico, Pier Francesco Rambaldi, Laura Perrone, Emanuele Miraglia del Giudice, Angela La Manna, and Cesare Polito Pierluigi MarzuilloPierluigi Marzuillo Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Stefano GuarinoStefano Guarino Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Anna GrandoneAnna Grandone Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Allegra Di SommaAllegra Di Somma Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Nicoletta Della VecchiaNicoletta Della Vecchia Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Tiziana EspositoTiziana Esposito Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Giulia MacchiniGiulia Macchini Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Rosaria MarottaRosaria Marotta Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Andrea ApicellaAndrea Apicella Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Mario DiplomaticoMario Diplomatico Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Pier Francesco RambaldiPier Francesco Rambaldi Department of Radiological Sciences, Nuclear Medicine, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Laura PerroneLaura Perrone Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Emanuele Miraglia del GiudiceEmanuele Miraglia del Giudice Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , Angela La MannaAngela La Manna Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy , and Cesare PolitoCesare Polito Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy View All Author Informationhttps://doi.org/10.1016/j.juro.2017.05.076AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the clinical course of patients prenatally diagnosed and enrolled early with congenital solitary functioning kidney, and identified the risk factors for renal injury. Materials and Methods: We retrospectively evaluated 322 patients with congenital solitary functioning kidney according to the inclusion criteria of 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 enrollment (1 to 3 months of life) confirmed by a normal estimated glomerular filtration rate, lack of proteinuria and hypertension. Followup of 306 patients was evaluated. Results: Median followup was 7.2 years (range 1 to 23) and 1 or more signs of renal injury were found in 12 of 306 patients (3.9%). Considering the entire population the cumulative proportion of patients free from renal injury at 17 years old was 93.7%, vs 81.3% and 95.9% for subjects with and those without congenital anomalies of the kidney and urinary tract of congenital solitary functioning kidney (p <0.001), respectively. Of congenital anomalies of the kidney and urinary tract, congenital solitary functioning kidney resulted in significant risk factors for renal injury (HR 8.75, 95% CI 2.77–27.65). Conclusions: In an evaluation of a large cohort of patients enrolled early with congenital solitary functioning kidney with a prenatal diagnosis, excluding those with neonatal onset of renal damage, the prevalence of renal damage was 3.9%. Among congenital anomalies of the kidney and urinary tract, congenital solitary functioning kidney represented the major risk factor. References 1 : Renal agenesis and unilateral nephrectomy: what are the risks of living with a single kidney?. Pediatr Nephrol2009; 24: 439. Google Scholar 2 : Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int2009; 76: 528. Google Scholar 3 : Risk factors for renal injury in children with a solitary functioning kidney. Pediatrics2013; 131: e478. Google Scholar 4 : Congenital solitary kidney in children: size matters. J Urol2016; 196: 1250. Link, Google Scholar 5 : Renal injury in children with a solitary functioning kidney–the KIMONO study. Nephrol Dial Transplant2011; 26: 1533. Google Scholar 6 : Clinical implications of the solitary functioning kidney. Clin J Am Soc Nephrol2014; 9: 978. Google Scholar 7 : KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl2012; 2: 1. Google Scholar 8 : The main etiologies of acute kidney injury in the newborns hospitalized in the neonatal intensive care unit. J Clin Neonatol2014; 3: 99. Google Scholar 9 : TM6SF2 Glu167Lys polymorphism is associated with low levels of LDL-cholesterol and increased liver injury in obese children. Pediatr Obes2016; 11: 115. Google Scholar 10 : The LMS method for constructing normalized growth standards. Eur J Clin Nutr1990; 44: 45. Google Scholar 11 : Sonographic assessment of renal length in normal children. AJR Am J Roentgenol1984; 142: 467. Crossref, Medline, Google Scholar 12 : The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am1987; 34: 571. Google Scholar 13 : The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics2004; 114: 555. Google Scholar 14 Report of the Second Task Force on Blood Pressure Control in Children–1987. Task Force on Blood Pressure Control in Children. National Heart, Lung, and Blood Institute, Bethesda, Maryland. Pediatrics1987; 79: 1. Google Scholar 15 : National Kidney Foundation's Kidney Disease Outcomes Quality Initiative clinical practice guidelines for chronic kidney disease in children and adolescents: evaluation, classification, and stratification. Pediatrics2003; 111: 1416. Google Scholar 16 : Solitary functioning kidney in children–a follow-up study. Kidney Blood Press Res2014; 39: 272. Google Scholar 17 : The risk of associated urological abnormalities in children with pre and postnatal occasional diagnosis of solitary, small or ectopic kidney: is a complete urological screening always necessary?. World J Urol2008; 26: 281. Google Scholar 18 : Copy number variation analysis identifies novel CAKUT candidate genes in children with a solitary functioning kidney. Kidney Int2015; 88: 1402. Google Scholar 19 : Pediatric Nephrology, 7th ed. Berlin: Springer-Verlag2016. Google Scholar 20 : Early progressive renal decline precedes the onset of microalbuminuria and its progression to macroalbuminuria. Diabetes Care2014; 37: 226. Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byMarzuillo P, Guarino S, Di Sessa A, Rambaldi P, Reginelli A, Vacca G, Cappabianca S, Capalbo D, Esposito T, De Luca Picione C, Arienzo M, Cirillo G, La Manna A, Miraglia del Giudice E and Polito C (2020) Congenital Solitary Kidney from Birth to AdulthoodJournal of Urology, VOL. 205, NO. 5, (1466-1475), Online publication date: 1-May-2021.Wan J (2017) This Month in Pediatric UrologyJournal of Urology, VOL. 198, NO. 5, (953-954), Online publication date: 1-Nov-2017. Volume 198Issue 5November 2017Page: 1153-1158Supplementary Materials Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.KeywordskidneyCAKUTproteinuriachildhypertensionAcknowledgmentsAnna Carella and Louise Daisley assisted in revising the manuscript language.MetricsAuthor Information Pierluigi Marzuillo Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Stefano Guarino Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Anna Grandone Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Allegra Di Somma Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Nicoletta Della Vecchia Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Tiziana Esposito Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Giulia Macchini Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Rosaria Marotta Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Andrea Apicella Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Mario Diplomatico Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Pier Francesco Rambaldi Department of Radiological Sciences, Nuclear Medicine, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Laura Perrone Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Emanuele Miraglia del Giudice Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Angela La Manna Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Cesare Polito Department of Woman, Child and of General and Specialized Surgery, Università degli Studi della Campania "Luigi Vanvitelli," Naples, Italy More articles by this author Expand All Advertisement PDF downloadLoading ...
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