Identifying risk factors for chronic kidney disease stage 3 in adults with acquired solitary kidney from unilateral nephrectomy: a retrospective cohort study

Abstract

Background We aimed to examine the risk factors for chronic kidney disease (CKD) stage 3 among adults with ASK from unilateral nephrectomy. Methods We retrospectively collected data from adult patients with ASK between January, 2009 and January, 2019, identified from a tertiary hospital in China. The clinical data were compared between patients who developed CKD stage 3 and those who did not develop CKD stage 3 during follow-up. Results In total, 172 patients with ASK (110 men; median 58.0 years) were enrolled, with a median follow-up duration of 5.0 years. During follow-up, 91 (52.9%) and 24 (14.0%) patients developed CKD stage 3 and end-stage renal disease, respectively. Multiple regression analyses showed that age (odds ratio [OR] 1.076, 95% confidence interval [CI] 1.039–1.115, p < 0.001), diabetes (OR 4.401, 95% CI 1.693–11.44, p = 0.002), hyperuricemia (OR 2.733, 95% CI 1.104–6.764, p = 0.03), a history of cardiovascular disease (CVD) (OR 5.583, 95% CI 1.884–18.068, p = 0.002), and ASK due to renal tuberculosis (OR 8.816, 95% CI 2.92–26.62, p < 0.001) were independent risk factors for developing CKD stage 3 among patients with ASK. Conclusions Regular follow-up of renal function is needed among adult patients with ASK. Optimal management of diabetes, hyperuricemia, and CVD may reduce their risk of CKD stage 3, especially among those that undergo unilateral nephrectomy for renal tuberculosis.

Risk stratification for children with a solitary functioning kidney

“…Modifiable risk factors, such as obesity, smoking, or diabetes, should be avoided as much as possible because of their associations with hypertension, albuminuria, and kidney function deterioration [11,23,24,27]. For diabetes, hypertension, and cardiovascular disease, a direct relation with faster development of CKD was shown in patients with SFK [18,28,29].…”

The Inter-Relation between Solitary Kidney and Diabetes Mellitus-What Patterns are Known?

“…In a recent retrospective study performed on 172 patients with SaSK, DM was an independent risk factor for chronic kidney disease (CKD) stage 3, with a nearly four-fold higher risk (OR 4.401, 95% CI 1.693-11.44, p=0.002) [14]. Similar findings were described in a 6.3 year follow-up study conducted on a cohort of 499 SaSK in which, after nephrectomy, DM was associated with low-eGFR (OR=8.96, P=0.002) and with high serum creatinine (OR=10, P <0.0001) [15].…”