Correlation between hypertrophy and risk of hypertension in congenital solitary functioning kidney

Zambaiti, Elisa; Sergio, Maria; Baldanza, Fabio; Corrado, Ciro; Pace, Maria Rita Di; Cimador, Marcello

doi:10.1007/s00383-018-4389-z

Cited by 12 publications

(10 citation statements)

References 32 publications

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Section: Should Ambulatory Blood Pressure Monitoring Be Performed In ...mentioning

confidence: 99%

“…Ten studies evaluated BP by ABPM in a total number of 379 children with CSK [ 28 , 32 , 37 , 70 – 75 , 85 ] (Table 7 ). Five studies reported data on kidney length for a total of 136 patients and about 86% presented compensatory enlargement [ 28 , 32 , 70 , 72 , 85 ]. Six studies reported data on ipsilateral CAKUT, which were present in a minority of patients [ 28 , 37 , 70 , 71 , 75 , 85 ], while in the study by Lubrano et al, 24 out of 38 had kidney scars [ 74 ].…”

Section: Should Ambulatory Blood Pressure Monitoring Be Performed In ...mentioning

confidence: 99%

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Management of the congenital solitary kidney: consensus recommendations of the Italian Society of Pediatric Nephrology

Scola

Ammenti²,

Bertulli

et al. 2022

Pediatr Nephrol

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Background In recent years, several studies have been published on the prognosis of children with congenital solitary kidney (CSK), with controversial results, and a worldwide consensus on management and follow-up is lacking. In this consensus statement, the Italian Society of Pediatric Nephrology summarizes the current knowledge on CSK and presents recommendations for its management, including diagnostic approach, nutritional and lifestyle habits, and follow-up. Summary of the recommendations We recommend that any antenatal suspicion/diagnosis of CSK be confirmed by neonatal ultrasound (US), avoiding the routine use of further imaging if no other anomalies of kidney/urinary tract are detected. A CSK without additional abnormalities is expected to undergo compensatory enlargement, which should be assessed by US. We recommend that urinalysis, but not blood tests or genetic analysis, be routinely performed at diagnosis in infants and children showing compensatory enlargement of the CSK. Extrarenal malformations should be searched for, particularly genital tract malformations in females. An excessive protein and salt intake should be avoided, while sport participation should not be restricted. We recommend a lifelong follow-up, which should be tailored on risk stratification, as follows: low risk: CSK with compensatory enlargement, medium risk: CSK without compensatory enlargement and/or additional CAKUT, and high risk: decreased GFR and/or proteinuria, and/or hypertension. We recommend that in children at low-risk periodic US, urinalysis and BP measurement be performed; in those at medium risk, we recommend that serum creatinine also be measured; in high-risk children, the schedule has to be tailored according to kidney function and clinical data.

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Section: Should Ambulatory Blood Pressure Monitoring Be Performed In ...mentioning

confidence: 99%

Section: Should Ambulatory Blood Pressure Monitoring Be Performed In ...mentioning

confidence: 99%

Management of the congenital solitary kidney: consensus recommendations of the Italian Society of Pediatric Nephrology

Scola

Ammenti²,

Bertulli

et al. 2022

Pediatr Nephrol

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“…It is well established that following a reduction in kidney mass whether it is congenital in origin or following unilateral nephrectomy in the child or the adult, there is marked compensatory kidney growth that is comprised of hypertrophy of both the kidney tubules and the glomerulus ( Moritz et al, 2002 , 2005 ; Singh et al, 2010 ; Fong et al, 2014 ; Chen et al, 2016 ; Wang et al, 2019 ; Zambaiti et al, 2019 ). In humans, compensatory kidney hypertrophy of the SFK begins as early as 20 weeks into gestation and by 36 weeks into gestation there is an ∼11% mean enlargement of the SFK compared with age matched controls ( Van Vuuren et al, 2012b ).…”

Section: Adaptations To a Sfkmentioning

confidence: 99%

Physiology and Pathophysiology of Compensatory Adaptations of a Solitary Functioning Kidney

et al. 2020

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Children born with a solitary functioning kidney (SFK) have an increased risk of hypertension and kidney disease from early in adulthood. In response to a reduction in kidney mass, the remaining kidney undergoes compensatory kidney growth. This is associated with both an increase in size of the kidney tubules and the glomeruli and an increase in single nephron glomerular filtration rate (SNGFR). The compensatory hypertrophy and increase in filtration at the level of the individual nephron results in normalization of total glomerular filtration rate (GFR). However, over time these same compensatory mechanisms may contribute to kidney injury and hypertension. Indeed, approximately 50% of children born with a SFK develop hypertension by the age of 18 and 20–40% require dialysis by the age of 30. The mechanisms that result in kidney injury are only partly understood, and early biomarkers that distinguish those at an elevated risk of kidney injury are needed. This review will outline the compensatory adaptations to a SFK, and outline how these adaptations may contribute to kidney injury and hypertension later in life. These will be based largely on the mechanisms we have identified from our studies in an ovine model of SFK, that implicate the renal nitric oxide system, the renin angiotensin system and the renal nerves to kidney disease and hypertension associated with SFK. This discussion will also evaluate current, and speculate on next generation, prognostic factors that may predict those children at a higher risk of future kidney disease and hypertension.

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“…An adequate length of the congenital solitary functioning kidney is a key parameter for renal function [10]. However, according to several theories and some evidence of remaining functional renal tissue in MCDK [11], the renal growth slope may be different between renal agenesis and MCDK [12].…”

Section: Introductionmentioning

confidence: 99%

Renal growth slope in children with congenital and acquired solitary functioning kidneys

et al. 2021

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Purpose: This study aimed to analyze the renal growth slope in children with congenital and acquired solitary functioning kidneys. Methods: This retrospective study included all renal ultrasonography examinations performed in children in the agenesis, multicystic dysplastic kidney (MCDK), or nephrectomy group between September 2002 and February 2019. We reviewed the images and recorded the contralateral kidney size only when there was no focal lesion. Linear mixed model or piecewise linear mixed model analyses with a time point of 24 months of age were performed. Results: There were 132 patients, including 26 patients in the agenesis group, 35 in the MCDK group, and 71 in the nephrectomy group. The nephrectomy group showed the largest baseline kidney size (7.4 cm vs. 5.3 cm in the agenesis group [P<0.001] and 5.2 cm in the MCDK group [P<0.001]) and the smallest overall growth slope (0.04 cm/mo vs. 0.06 cm/mo in the agenesis group [P=0.004] and 0.07 cm/mo in the MCDK group [P<0.001]). However, considering the time point of 24 months for reaching adult renal function, there were significant changes in slope, from 0.1 cm/mo before 24 months of age to 0.03 cm/mo after 24 months of age in all three groups (P<0.001), without a significant difference among the groups. Conclusion: Significant changes were found in the renal growth slope before and after 24 months of age, with no significant difference between congenital and acquired solitary functioning kidneys.

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Correlation between hypertrophy and risk of hypertension in congenital solitary functioning kidney

Cited by 12 publications

References 32 publications

Management of the congenital solitary kidney: consensus recommendations of the Italian Society of Pediatric Nephrology

Management of the congenital solitary kidney: consensus recommendations of the Italian Society of Pediatric Nephrology

Physiology and Pathophysiology of Compensatory Adaptations of a Solitary Functioning Kidney

Renal growth slope in children with congenital and acquired solitary functioning kidneys

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