Lubrano Riccardo, Gentile Isotta, Falsaperla Raffaele, Vitaliti Giovanna, Marcellino Alessia, Elli Marco
Pediatric Department, Pediatric Nephrology Unit, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
General Pediatrics and Pediatric Acute and Emergency Unit, Policlinico-Vittorio-Emanuele University Hospital, Catania, Italy.
Ital J Pediatr. 2017 Apr 27;43(1):43. doi: 10.1186/s13052-017-0359-7.
It is not yet clear if blood pressure and renal function changes evolve differently in children with a congenital or acquired solitary functioning kidney. This study aims to assess if there are any differences between these two types of solitary kidney patients.
Current research is a retrospective study assessing the evolution of glomerular filtration rate, proteinuria, and blood pressure in clinical records of 55 children with a solitary functioning kidney (37 congenital and 18 acquired). We used the medical records of children who had been assisted, in our unit of pediatric nephrology, for a period of 14 years (168 months), from the time of diagnosis, between January/1997 and December/2015.
During the study period, glomerular filtration rate (T0 128.89 ± 32.24 vs T14 118.51 ± 34.45 ml/min/1.73 m, p NS) and proteinuria (T0 85.14 ± 83.13 vs T14 159.03 ± 234.66 mg/m/die, p NS) demonstrated no significant change. However, after 14 years of follow-up 76.4% of patients had increased levels of arterial hypertension with values over the 90th percentile for gender, age, and height. Specifically, children with an acquired solitary functioning kidney mainly developed hypertension [T0 2/17 (12%) vs T14 9/17 (52.9%) p < 0.025], whereas children with a congenital solitary functioning kidney mainly developed pre-hypertension [T0 3/38 (7.9%) vs T14 17/38 (44.7%) p < 0.0005].
The renal function of children with solitary functioning kidneys remains stable during a follow-up of 14 years. However, these children should be carefully monitored for their tendency to develop arterial blood pressure greater than the 90th percentile for gender, age, and height.
先天性或后天性单肾患儿的血压和肾功能变化是否存在不同演变尚不清楚。本研究旨在评估这两种类型的单肾患者之间是否存在差异。
当前研究为一项回顾性研究，评估了55名单肾患儿（37例先天性和18例后天性）临床记录中的肾小球滤过率、蛋白尿和血压演变情况。我们使用了在我们儿科肾脏病科接受治疗14年（168个月）的患儿的病历，时间从1997年1月诊断开始至2015年12月。
在研究期间，肾小球滤过率（T0为128.89±32.24 vs T14为118.51±34.45 ml/min/1.73 m²，p无统计学意义）和蛋白尿（T0为85.14±83.13 vs T14为159.03±234.66 mg/m²/天，p无统计学意义）均无显著变化。然而，经过14年的随访，76.4%的患者出现动脉高血压水平升高，其值超过性别、年龄和身高的第90百分位数。具体而言，后天性单肾患儿主要发展为高血压[T0为2/17（12%）vs T14为9/17（52.9%），p<0.025]，而先天性单肾患儿主要发展为高血压前期[T0为3/38（7.9%）vs T14为17/38（44.7%），p<0.0005]。
单肾患儿的肾功能在14年的随访期间保持稳定。然而，这些患儿应密切监测其动脉血压高于性别、年龄和身高第90百分位数的倾向。
