Hegde Shivaram, Coulthard Malcolm G
Department of Paediatric Nephrology, Royal Victoria Infirmary, Newcastle, NE1 4LP, UK.
Pediatr Nephrol. 2009 Mar;24(3):439-46. doi: 10.1007/s00467-008-0924-9. Epub 2008 Jul 9.
The long-term outlook for patients with unilateral renal agenesis or following unilateral nephrectomy in childhood is controversial. Animal studies suggest that the resultant compensatory increase in glomerular filtration might lead to progressive damage to the remaining renal tissue and may generate hypertension. Human studies addressing these concerns are limited in number and are difficult to interpret because they are small, retrospective, or cross sectional with significant variations in duration and completeness of follow-up. The published studies suggest that renal function remains stable for several decades in the majority of subjects. The clinical significance of mild-grade proteinuria and hypertension seen in some patients is unknown. Longitudinal studies are needed to understand the long-term effect and significance of the several pathophysiological changes observed in the solitary kidney.
单侧肾发育不全患者或儿童期单侧肾切除术后的长期预后存在争议。动物研究表明，由此导致的肾小球滤过代偿性增加可能会导致剩余肾组织的渐进性损伤，并可能引发高血压。针对这些问题的人体研究数量有限，且由于样本量小、为回顾性研究或横断面研究，随访时间和完整性存在显著差异，因此难以解读。已发表的研究表明，大多数受试者的肾功能在几十年内保持稳定。一些患者出现的轻度蛋白尿和高血压的临床意义尚不清楚。需要进行纵向研究来了解在单肾中观察到的几种病理生理变化的长期影响和意义。
