Argueso L R, Ritchey M L, Boyle E T, Milliner D S, Bergstralh E J, Kramer S A
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.
Pediatr Nephrol. 1992 Sep;6(5):412-6. doi: 10.1007/BF00873996.
The clinical course was reviewed in 157 patients with unilateral renal agenesis and a normal contralateral kidney for the purpose of establishing a prognosis. There were 85 males (54%) and 72 females (46%). The mean age at diagnosis of unilateral renal agenesis was 37 years. The mean years at risk was 56. Proteinuria (> 150 mg/24 h) was found in 19% of the 37 patients tested (P < 0.001), hypertension developed in 47% of the 47 patients tested (P = 0.010), and renal function (adjusted for age and sex) was decreased in 13% of the 32 patients tested (P = 0.001). An increased filtration fraction was found in 7 (54%) of 13 patients evaluated. At the completion of this study, 114 patients (73%) were alive, and the survival rate was similar to that of age-, sex-matched United States life tables. Forty-three patients (27%) died; 6 deaths (4%) were caused by renal failure. Our review indicates that patients with unilateral renal agenesis and a normal solitary kidney are at increased risk of proteinuria, hypertension, and renal insufficiency. Therefore, it is essential to have prolonged and careful follow-up and to employ strategies that maximize renal preservation.
为了确定预后，对157例单侧肾缺如且对侧肾脏正常的患者的临床病程进行了回顾。其中男性85例（54%），女性72例（46%）。单侧肾缺如诊断时的平均年龄为37岁。平均危险年限为56年。在接受检测的37例患者中，19%发现蛋白尿（>150mg/24小时）（P<0.001）；在接受检测的47例患者中，47%出现高血压（P=0.010）；在接受检测的32例患者中，13%的患者肾功能（根据年龄和性别校正后）下降（P=0.001）。在接受评估的13例患者中，7例（54%）发现滤过分数增加。在本研究结束时，114例患者（73%）存活，生存率与年龄、性别匹配的美国生命表相似。43例患者（27%）死亡；6例死亡（4%）由肾衰竭引起。我们的回顾表明，单侧肾缺如且有一个正常孤立肾的患者蛋白尿、高血压和肾功能不全的风险增加。因此，必须进行长期、仔细的随访，并采用最大限度保护肾脏的策略。
