Department of Pediatric Nephrology, VU University Medical Center, Amsterdam, The Netherlands.
J Urol. 2010 Apr;183(4):1574-8. doi: 10.1016/j.juro.2009.12.041. Epub 2010 Feb 21.
Urological characteristics of renal ectopia have been addressed previously but little is known about the functional consequences. We sought to study renal function, blood pressure, proteinuria and urological abnormalities in children with renal ectopia. As a secondary objective, we compared these parameters between simple and crossed ectopia.
For this retrospective, single center, observational study we reviewed case documents and radiological records. We also analyzed longitudinal data on blood pressure, proteinuria and kidney function.
Renal ectopia was diagnosed in 41 cases, of which 26 (63%) were simple renal ectopia, ie unilateral pelvic kidney. In 32% of patients the diagnosis was made during prenatal screening. Median patient age was 0.24 years at diagnosis and 7.7 years at the most recent control visit. Associated urological abnormalities were found in 66% of patients. Voiding cystourethrography was performed in all patients, with vesicoureteral reflux shown in 13. In 8 of 10 cases with unilateral reflux the condition manifested in the orthotopic kidney. The relative function of the ectopic kidney on dimercapto-succinic acid scan was 38%, and in 22% of patients glomerular filtration rate was less than 90 ml per minute per 1.73 m(2). Albuminuria and proteinuria were absent in most cases. Longitudinal analysis of blood pressure, glomerular filtration rate and albuminuria revealed a stable course for all parameters. No substantial difference was observed between simple and crossed renal ectopia.
Our data suggest no adverse effects on blood pressure or kidney function in children with renal ectopia. However, periodic followup seems warranted, at least until young adulthood.
先前已经探讨过肾异位的泌尿科特征，但对其功能后果知之甚少。我们旨在研究肾异位儿童的肾功能、血压、蛋白尿和泌尿科异常。作为次要目标，我们比较了单纯性和交叉性肾异位之间的这些参数。
本回顾性、单中心、观察性研究回顾了病例资料和影像学记录。我们还分析了血压、蛋白尿和肾功能的纵向数据。
共诊断出 41 例肾异位，其中 26 例（63%）为单纯性肾异位，即单侧骨盆肾。32%的患者在产前筛查中诊断出。患者的中位诊断年龄为 0.24 岁，最近一次随访时为 7.7 岁。66%的患者存在相关的泌尿科异常。所有患者均行排尿性膀胱尿道造影检查，其中 13 例显示有输尿管反流。在 10 例单侧反流中，8 例在正常位置的肾脏中出现该情况。二巯丁二酸扫描显示异位肾的相对功能为 38%，22%的患者肾小球滤过率低于每分钟每 1.73 m2 90ml。大多数情况下，患者均无白蛋白尿和蛋白尿。血压、肾小球滤过率和白蛋白尿的纵向分析显示所有参数的病程稳定。单纯性和交叉性肾异位之间未见明显差异。
我们的数据表明肾异位儿童的血压或肾功能无不良影响。然而，似乎需要定期随访，至少随访至成年早期。
