Is renal scintigraphy really a necessity in the routine diagnosis of congenital solitary kidney?

Grabnar, Jera; Rus, Rina

doi:10.1007/s00383-019-04478-1

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…Ultrasound screening of the kidneys and urinary tract is the main diagnostic tool for evaluation of a patient with a cSFK, given its noninvasive nature and high accuracy for diagnosing a cSFK ( Table 1 ) [18] , [19] , [20] . At the first postnatal ultrasound, an attempt should be made to confirm prenatal findings and establish a definitive diagnosis.…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Kidney scintigraphy using radioactively labeled dimercaptosuccinic acid (DMSA) or mercapto acetyl tri glycine (MAG-3) can be used to visualize functioning kidney tissue. These studies are not needed routinely when URA or MCDK is suspected, since these diagnoses can be made accurately using sonographic studies of the kidney in >95% of cases [18] , [19] , [20] . Although a DMSA scan is more time consuming for the patients and parents involved, it may be indicated to visualize kidney scarring after a pyelonephritis.…”

Section: Evidence Synthesismentioning

confidence: 99%

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Clinical Management of Children with a Congenital Solitary Functioning Kidney: Overview and Recommendations

Woud

Westland

Feitz

et al. 2021

European Urology Open Science

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Context A congenital solitary functioning kidney (cSFK) is a common developmental defect that predisposes to hypertension and chronic kidney disease (CKD) as a consequence of hyperfiltration. Every urologist takes care of patients with a cSFK, since some will need lifelong urological care or will come with clinical problems or questions to an adult urologist later in life. Objective We aim to provide clear recommendations for the initial clinical management and follow-up of children with a cSFK. Evidence acquisition PubMed and EMBASE were searched to identify relevant publications, which were combined with guidelines on related topics and expert opinion. Evidence synthesis Initially, cSFK diagnosis should be confirmed and risk factors for kidney injury should be identified using ultrasound. Although more research into early predictors of kidney injury is needed, additional congenital anomalies of the kidney or urinary tract and absence of compensatory kidney hypertrophy have repeatedly been associated with a worse prognosis. The role of voiding cystourethrography and antibiotic prophylaxis remains controversial, and is complicated by the exclusion of children with a cSFK from studies. A yearly follow-up for signs of kidney injury is recommended for children with a cSFK. As masked hypertension is prevalent, annual ambulatory blood pressure measurement should be considered. During puberty, an increasing incidence of kidney injury is seen, indicating that long-term follow-up is necessary. If signs of kidney injury are present, angiotensin converting enzyme inhibitors are the first-line drugs of choice. Conclusions This overview points to the urological and medical clinical aspects and long-term care guidance for children with a cSFK, who are at risk of hypertension and CKD. Monitoring for signs of kidney injury is therefore recommended throughout life. Large, prospective studies with long-term follow-up of clearly defined cohorts are still needed to facilitate more risk-based and individualized clinical management. Patient summary Many children are born with only one functioning kidney, which could lead to kidney injury later in life. Therefore, a kidney ultrasound is made soon after birth, and other investigations may be needed as well. Urologists taking care of patients with a solitary functioning kidney should realize the long-term clinical aspects, which might need medical management.

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Section: Evidence Synthesismentioning

confidence: 99%

Section: Evidence Synthesismentioning

confidence: 99%

Clinical Management of Children with a Congenital Solitary Functioning Kidney: Overview and Recommendations

Woud

Westland

Feitz

et al. 2021

European Urology Open Science

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“…Furthermore, 32 studies were excluded because they were review articles or animal studies. Eventually, a total of 41 studies were included in this meta‐analysis 18–57 . According to the PRISMA guidelines, an overall data collection process is presented in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…The results of a total of 20 studies were evaluated in this category. 18,[20][21][22]24,[26][27][28][32][33][34][35]37,40,43,52,[54][55][56][57] Left RA was found in 51.56% (95% CI: 44.79%-58.31%) out of a total of 1182 subjects and right RA had a prevalence of 43.19% (95% CI: 36.65%-49.84%) in 1182 patients. More information is provided in Table 5.…”

Section: Occurrence Of the Ra Sidementioning

confidence: 99%

Renal agenesis: A meta‐analysis of its prevalence and clinical characteristics based on 15 641 184 patients

et al. 2023

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Our objective was to analyse the newest relevant data on worldwide prevalence and associated symptoms of renal agenesis (RA). This meta‐analysis builds on previous systematic reviews to include bilateral RA, its symptoms and data on gender, unilateral RA and anomaly location prevalence. Review of available data included records in English and other languages from PubMed, Embase, ScienceDirect, Web of Science, SciELO, BIOSIS, Current Content Connect Korean Journal Database and Russian Citation Index and Google. A total of 15 641 184 patients were analysed in relation to the prevalence of RA. The pooled prevalence of RA was 0.03% (95% CI: 0.03%–0.04%). Based on 500 subjects, a pooled prevalence of 47.96% (95% CI: 31.55%–64.58%) for unilateral and 52.04% (95% CI: 35.42%–68.45%) for bilateral RA has been set. Our study presents the newest generalized findings on bilateral RA. There appears to be universal disease and symptom prevalence with minor differences between world regions, although quality of future observational research should include genomic data. This will provide even further insight into the prognosis of various renal anomalies and their etiologies.

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“…8,9 Tanıyı doğrulamak ve kesin tanı koymak için bazı yayınlar rutin DMSA çekilmesini önermese de genel fikir birliği bu hastalara DMSA çekilmesi yönündedir. 10,11 Çalışmamızda tanı anında >1 yaş olan her hastaya tanıyı doğrulamak amaçlı DMSA yapıldı. Antenatal tanı alan veya tanı anında <1 yaş olan hastalarda ise DMSA çekimi, endikasyon olmadığı sürece 1 yaşından sonraya bırakıldı.…”

Section: Yöntemunclassified

Agenezi veya Multikistik Displazi: Doğuştan Tek Böbrekli Çocuklarda Hangisi Daha Kötü?

Çelakıl

Özgür

Bek

2020

Kocaeli Üniversitesi Sağlık Bilimleri Dergisi

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Renal agenezi ve Multikistik Displastik Böbrek (MKDB), gelişimsel böbrek kusurlarındandır. Her iki hastalıkta da fonksiyon gören tek böbrek mevcuttur. Yapılan çalışmalarda her iki hastalık ayrı ayrı incelenmiş ve uzun dönem sonuçları paylaşılmıştır. Yöntem: Çalışmaya Kocaeli Tıp Fakültesi Çocuk Nefroloji Polikliniğinden takipli olan 103 tek taraflı renal agenezi, 76 tek taraflı MKDB tanılı toplam 179 hastanın dosyaları geriye dönük olarak tarandı. Hastaların yaş, cinsiyet, ailede üriner sistem anomali öyküsü, antenatal tanı öyküsü, oligohidramnios öyküsü, eşlik eden ek hastalık öyküsü, cerrahi öyküsü ve anne-baba akrabalığı kaydedildi. Renal agenezi ve MKDB hastaları epidemiyolojik, etiyolojik, klinik ve prognostik faktörler açısından karşılaştırıldı. Bulgular: Tanı yaşı MKDB'de ortanca 1 ay (0-156), renal agenezilerde 48 ay (6-96) olarak bulundu (p<0,01). Antenatal tanı MKDB'de %82,7 (62), renal agenezilerde %49,5 (51) idi (p<0,001). Renal agenezilerde kız/erkek oranı 0,56 (37 kız, 66 erkek), multikistik displazilerde 1,02 (38 kız,37 erkek) idi (p<0,05). Her iki grupta da hastalık sol tarafta daha sıktı (MKDB 44 hasta, renal agenezi 67 hasta). Multikistik displastik böbrek tanısı alan 4 (%5,4) hastada doğum sırasında karşı taraftaki böbrekte hipertrofi mevcuttu. Takip eden yıllarda karşı tarafta hipertrofi gelişimi iki grup arasında benzerdi (MKDB %38,7, renal agenezi %46,1). Karşı tarafta hipertrofi başlama zamanı MKDB hastalarında anlamlı derecede daha erkendi (MKDB 32 ay, renal agenezi 72 ay) (p<0,05). Takip süreleri boyunca mikroalbuminüri görülme riski MKDB hastalarında anlamlı derecede yüksekti (renal agenezilerde %14,6, MKDB'de %30,3) (p<0,05). Sonuç: Her iki hastalık da uzun dönem takibi açısından iyi prognozludur. Hastalara rutin voiding sistoüreterografi (VCUG) çekilmesine ve rutin nefrektomi uygulamasına gerek yoktur.

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Is renal scintigraphy really a necessity in the routine diagnosis of congenital solitary kidney?

Cited by 5 publications

References 17 publications

Clinical Management of Children with a Congenital Solitary Functioning Kidney: Overview and Recommendations

Clinical Management of Children with a Congenital Solitary Functioning Kidney: Overview and Recommendations

Renal agenesis: A meta‐analysis of its prevalence and clinical characteristics based on 15 641 184 patients

Agenezi veya Multikistik Displazi: Doğuştan Tek Böbrekli Çocuklarda Hangisi Daha Kötü?

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