The natural history of solitary post-nephrectomy kidney in a pediatric population.
Acidosis, Renal Tubular
/ epidemiology
Adolescent
Age of Onset
Child
Child, Preschool
Colombia
/ epidemiology
Female
Follow-Up Studies
Glomerular Filtration Rate
/ physiology
Humans
Hypertension
/ epidemiology
Infant
Infant, Newborn
Male
Nephrectomy
/ adverse effects
Postoperative Period
Prevalence
Prognosis
Proteinuria
/ epidemiology
Renal Insufficiency, Chronic
/ epidemiology
Retrospective Studies
Risk Factors
Solitary Kidney
/ epidemiology
Nephrectomy
Renal Insufficiency
Solitary Kidney
Journal
International braz j urol : official journal of the Brazilian Society of Urology
ISSN: 1677-6119
Titre abrégé: Int Braz J Urol
Pays: Brazil
ID NLM: 101158091
Informations de publication
Date de publication:
Historique:
received:
27
10
2018
accepted:
16
06
2019
entrez:
7
12
2019
pubmed:
7
12
2019
medline:
23
1
2020
Statut:
ppublish
Résumé
Children with a solitary post-nephrectomy kidney (SNK) are at potential risk of developing kidney disease later in life. In response to the global decline in the number of nephrons, adaptive mechanisms lead to renal injury. The aim of this study was to determine the prevalence and time of onset of high blood pressure (HBP), proteinuria, glomerular filtration rate (GFR) disruption and renal tubular acidosis (RTA) in children with SNK. After obtaining the approval from our institution's ethics committee, we reviewed the medical records of patients under 18 years of age who underwent unilateral nephrectomy between January 2005 and December 2015 in three university hospitals. We identifi ed 43 patients, 35 (81.4%) cases of unilateral nephrectomy (UNP) were due to a non-oncologic pathology and Wilm's tumor was identified in 8 (18.6%) cases. In patients with non-oncologic disease, 9.3% developed de novo hypertension, with an average time of onset of 7.1 years, 25% developed proteinuria de novo, with an average time of onset of 2.2 years. For GFR, 21.8% presented deterioration of the GFR in an average time of 3.4 years. Ten (43.5%) patients developed some type of de novo renal injury after UNP. Patients with oncolo-gic disease developed the conditions slowly and none of them developed proteinuria. Taking into account the high rate of long term postoperative renal injury, it can be considered that nephrectomy does not prevent this disease. The follow-up of children with SNK requires a multidisciplinary approach and long-term surveillance to detect renal injury.
Identifiants
pubmed: 31808412
doi: 10.1590/S1677-5538.IBJU.2018.0291
pii: IBJU20180291
pmc: PMC6909849
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1227-1237Informations de copyright
Copyright® by the International Brazilian Journal of Urology.
Déclaration de conflit d'intérêts
None declared.
Références
Pediatr Blood Cancer. 2013 Dec;60(12):1929-35
pubmed: 24039069
Kidney Int. 1996 Jun;49(6):1774-7
pubmed: 8743495
N Engl J Med. 2011 Dec 22;365(25):2398-411
pubmed: 22187987
Kidney Blood Press Res. 2014;39(4):272-8
pubmed: 25171427
Pediatr Nephrol. 2014 Nov;29(11):2205-11
pubmed: 24908323
Nephrol Dial Transplant. 2011 May;26(5):1533-41
pubmed: 21427076
Pediatrics. 2013 Feb;131(2):e478-85
pubmed: 23319536
Pediatr Nephrol. 2007 Apr;22(4):559-64
pubmed: 17216255
Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266
pubmed: 11904577
Kidney Int. 2005 Jul;68(1):263-70
pubmed: 15954916
Clin J Am Soc Nephrol. 2014 May;9(5):978-86
pubmed: 24370773
Pediatrics. 2004 Aug;114(2 Suppl 4th Report):555-76
pubmed: 15286277
Kidney Int. 2009 Sep;76(5):528-33
pubmed: 19536081
Clin Biochem. 2012 Oct;45(15):1173-7
pubmed: 22732526
Pediatr Nephrol. 2016 Mar;31(3):435-41
pubmed: 26482253