TY - JOUR
T1 - Is the prognosis of congenital single functioning kidney benign? A population-based study
AU - Alfandary, Hadas
AU - Haskin, Orly
AU - Goldberg, Ori
AU - Dagan, Amit
AU - Borovitz, Yael
AU - Levi, Shelly
AU - Davidovits, Miriam
AU - Erlich, Tomer
AU - Landau, Daniel
AU - Pleniceanu, Oren
N1 - Publisher Copyright:
© 2021, IPNA.
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Background: We investigated the risk of kidney injury among adolescents with and without a congenital single functioning kidney (SFK). Methods: This retrospective study is based on a medical evaluation database of 17-year-old Israeli conscripts, born during 1989–1999. Those with congenital SFK diagnosis, verified by a pediatric nephrologist’s review of the original military medical committee classifications, were compared to the rest of the cohort. Kidney injury (KI) was defined as proteinuria, high blood pressure (BP), or estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m2 prior to army recruitment. Risk factors for KI were examined using logistic regression. Results: Of 979,630 screened candidates, 353 were diagnosed with SFK. The yearly incidence of SFK gradually increased in the first years of the study, reaching a plateau in 1995 (5.5 ± 1.2/10,000 births/year). The male to female ratio was 2.7:1. Concomitant genital malformations were documented in 5.5% of those with SFK. KI was more prevalent in the SFK than the control group (42.2% vs. 23.5%, p < 0.001). All three components of KI were more common in the SFK than the control group: high BP (31.7% vs. 23.1%, p < 0.001), proteinuria (18.2% vs. 0.4%, p < 0.001), and eGFR <90 ml/min/1.73m2 (12.0% vs 0.1%, p < 0.001). Multivariate analysis of the SFK group revealed associations of higher mean BMI, male sex, and smaller ultrasonographic kidney length with KI. Conclusions: This large population-based study documents a significant risk for KI among adolescents with SFK. Obesity represents a major modifiable risk factor for KI, implicating the need for closer follow-up in this group during childhood.
AB - Background: We investigated the risk of kidney injury among adolescents with and without a congenital single functioning kidney (SFK). Methods: This retrospective study is based on a medical evaluation database of 17-year-old Israeli conscripts, born during 1989–1999. Those with congenital SFK diagnosis, verified by a pediatric nephrologist’s review of the original military medical committee classifications, were compared to the rest of the cohort. Kidney injury (KI) was defined as proteinuria, high blood pressure (BP), or estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m2 prior to army recruitment. Risk factors for KI were examined using logistic regression. Results: Of 979,630 screened candidates, 353 were diagnosed with SFK. The yearly incidence of SFK gradually increased in the first years of the study, reaching a plateau in 1995 (5.5 ± 1.2/10,000 births/year). The male to female ratio was 2.7:1. Concomitant genital malformations were documented in 5.5% of those with SFK. KI was more prevalent in the SFK than the control group (42.2% vs. 23.5%, p < 0.001). All three components of KI were more common in the SFK than the control group: high BP (31.7% vs. 23.1%, p < 0.001), proteinuria (18.2% vs. 0.4%, p < 0.001), and eGFR <90 ml/min/1.73m2 (12.0% vs 0.1%, p < 0.001). Multivariate analysis of the SFK group revealed associations of higher mean BMI, male sex, and smaller ultrasonographic kidney length with KI. Conclusions: This large population-based study documents a significant risk for KI among adolescents with SFK. Obesity represents a major modifiable risk factor for KI, implicating the need for closer follow-up in this group during childhood.
KW - Hypertension
KW - Kidney failure
KW - Kidney injury
KW - Proteinuria
KW - Single kidney
KW - Solitary kidney
UR - http://www.scopus.com/inward/record.url?scp=85101299722&partnerID=8YFLogxK
U2 - 10.1007/s00467-021-04980-6
DO - 10.1007/s00467-021-04980-6
M3 - Article
C2 - 33619660
AN - SCOPUS:85101299722
SN - 0931-041X
VL - 36
SP - 2837
EP - 2845
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 9
ER -