Solitary kidney (SK) is a congenital or acquired condition characterized by a functional or anatomical absence of the controlateral kidney [1].
Defects in kidney development are part of the Congenital Anomalies of the Kidney and Urinary Tract (CAKUT).1 CAKUT include several clinical entities, from complete renal agenesis to hypodysplasia or renal dysplasia.
The purpose of this study is to evaluate the clinical course and the long-term outcome of children with SK.
Methods
We retrospectively evaluated 209 children affected by SK followed in our center in the last 20 years (1998 – 2017), 150 males (71.7%) and 59 females (28.2%). All patients were subjected to urine exam, glomerular filtration rate (GFR), cystatin C, ultrasound monitoring, sequential
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Out of a total of 209, 52 patients (24.8%), 39 males and 13 females, had complex single kidney.
Contralateral kidney compensatory hypertrophy was found in 184/209 patients (88%). 6/209 (2.87%) of the total had associated syndromes or delay of neurologic development.
Two children (0.9%) have a glomerular filtrate reduced compared to the lower limit expected for ages. In 4/209 pz (1.9%) proteinuria (100 mg/dl) was found in the urinary sediment. Systolic blood pressure values greater than 95 C for ages were found in 3 patient (1.4%). Only 17/209 children (8.1%) developed recurrent urinary tract infections. We found no malignant degeneration.
Conclusions
Most children with SK are in good health [1]. In cases of uncomplicated solitary kidney, natural history shows a favorable prognosis [2] and there is no indication of nephrectomy [1] unless is present a dysplastic kidney with a size that can cause significant abdominal pain in the post-natal period. VCUG is no longer a recommended instrumental study for all patients with SK [3] and should only be performed in selected cases. Follow-up should be performed with renal function monitoring, urinary tract examination, arterial blood pressure control [4] and ultrasound evaluation once a year and more rigorously in patients with complex SK who had a higher risk of develop urinary
Nephrotic Syndrome, is when there is an increased in glomerular basement membrane permeability. This causes an excess loss of protein in the urine known as proteinuria. Congenital, idiopathic and secondary are forms of Nephrotic syndrome. Congenital nephrotic syndrome is rare, can be inherited and usually occur in Finnish families. Nephrotic syndrome is consider secondary if it occurs secondary to diseases like diabetes, systemic lupus erythematosus, or Henoch-Schonlein purpura. Idiopathic nephrotic syndrome, also known as minimal change nephrotic syndrome (MCNS) occurs mostly in kids with 70% occurring in kid 5 years old and younger. This paper will be focusing on MCNS (Kyle & Carman, 2013).
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