| Abstract [eng] |
Children with solitary functioning kidney have an increased risk of developing arterial hypertension and chronic kidney disease because of reduced functional kidney mass. Data on the development of these complications is conflicting, particularly that related to the role of solitary functioning kidney length. The aim of this study was to assess the prevalence of chronic kidney disease and arterial hypertension and their risk factors in children with solitary functioning kidney. A prospective cohort study was conducted. Kidney length was standardised by estimating standard deviation scores according to height. Arterial hypertension was assessed by ambulatory blood pressure monitoring and heart ultrasound was also performed to determine left ventricular geometry. Estimated glomerular filtration rate was calculated using Schwartz equation. Arterial hypertension was defined according to European Society of Hypertension guidelines. Composite outcome was defined as arterial hypertension and/or chronic kidney disease. 41 patients (51% boys, median age 7.6 years) were included. Chronic kidney disease was identified in 19 (46%), arterial hypertension in 10 (24%) and composite outcome in 25 (61%) patients. Solitary functioning kidney length standard deviation score correlated with glomerular filtration rate (r=0.557, p<0.01). Higher solitary functioning kidney length standard deviation score associated with decreased risk of chronic kidney disease and composite outcome (OR 0.61, p=0.03 and OR 0.61, p=0.045 respectively), while small kidney (<50 percentile) was associated with higher odds of chronic kidney disease (OR 5.83, p=0.045). Uric acid concentration correlated with glomerular filtration rate (r=-0.525, p<0.001) and was linked to higher odds of chronic kidney disease (OR 1.02, p=0.008). Arterial hypertension was associated with urinary tract infection history and family history of congenital renal anomaly (OR 6.5, p=0.024 and OR 12.4, p=0.04 respectively), however the precision of these results is low. Left ventricular hypertrophy was discovered in one (2.44%) and concentric remodeling in 5 (12.2%) patients. Children with solitary functioning kidney exhibit increased risk of arterial hypertension and chronic kidney disease. The risk of developing chronic kidney disease is related to kidney length, however factors that determine risk of arterial hypertension remain unclear. |
