Abstract
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/24h) 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.
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Klahr S, Purkerson M, Harris K (1986) Mechanisms of progressive renal failure in experimental animals and their applicability to man. In: Brenner BM, Stein JH (eds) Contemporary issues in nephrology, vol 14. Churchill Livingstone, New York, pp 1182–1191
Anderson S, Meyer TW, Brenner BM (1985) The role of hemodynamic factors in the initiation and progression of renal disease. J Urol 133: 363–368
Kiprov DD, Colvin RB, McCluskey RT (1982) Focal and segmental glomerulosclerosis and proteinuria associated with unilateral renal agenesis. Lab Invest 46: 275–281
Weinstein T, Gafter U, Levi J, Zevin D, Ben-Bassat M (1985) Proteinuria and chronic renal failure associated with unilateral renal agenesis. Isr J Med Sci 21: 919–921
Rugiu C, Oldrizzi L, Lupo A, Valvo E, Loschiavo C, Tessitore N, Gammaro L, Ortalda V, Fabris A, Panzetta G, Maschio G (1986) Clinical features of patients with solitary kidneys. Nephron 43: 10–15
Thorner PS, Arbus GS, Celermajer DS, Baumal R (1984) Focal segmental glomerulosclerosis and progressive renal failure associated with a unilateral kidney. Pediatrics 73: 806–810
Gutierrez-Millet V, Nieto J, Praga M, Usera G, Martinez MA, Morales JM (1986) Focal glomerulosclerosis and proteinuria in patients with solitary kidneys. Arch Intern Med 146: 705–709
Bhathena DB, Julian BA, McMorrow RG, Baehler RW (1985) Focal sclerosis of hypertrophied glomeruli in solitary functioning kidneys of humans. Am J Kidney Dis 5: 226–232
Robitaille P, Lortie L, Mongeau J-G, Sinnassamy P (1985) Long-term follow-up of patients who underwent unilateral nephrectomy in childhood. Lancet I: 1297–1299
Wikstad I, Celsi G, Larsson L, Herin P, Aperia A (1988) Kidney function in adults born with unilateral renal agenesis or nephrectomized in childhood. Pediatr Nephrol 2: 177–182
Argueso LR, Ritchey ML, Boyle ET Jr, Milliner DS, Bergstralh EJ, Kramer SA (1992) Prognosis of children with solitary kidney after unilateral nephrectomy. J Urol (in press)
Rowe JW, Andres R, Tobin JD, Norris AH, Shock NW (1976) The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study. J Gerontol 31: 155–163
Drizd T, Dannenberg AL, Engel A (1986) Blood pressure levels in persons 18–74 years of age in 1976–80, and trends in blood pressure from 1960 to 1980 in the United States. Vital Health Stat [11] 234: 1–68
Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53: 457–481
Doroshow LW, Abeshouse BS (1961) Congenital unilateral solitary kidney: report of 37 cases and a review of the literature. Urol Survey 11: 219–229
Longo VJ, Thompson GJ (1952) Congenital solitary kidney. J Urol 68: 63–68
Dees JE (1960) Prognosis of the solitary kidney. J Urol 83: 550–552
Emmanuel B, Nachman R, Aronson N, Weiss H (1974) Congenital solitary kidney: a review of 74 cases. Am J Dis Child 127: 17–19
Ashley DJB, Mostofi FK (1960) Renal agenesis and dysgenesis. J Urol 83: 211–230
Mitch WE (1984) The influence of the diet on the progression of renal insufficiency. Annu Rev Med 35: 249–264
Anderson S, Rennke H, Brenner BM (1986) Therapeutic advantage of converting enzyme inhibitors in arresting progressive renal disease associated with systemic hypertension in the rat. J Clin Invest 77: 1993–2000
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Argueso, L.R., Ritchey, M.L., Boyle, E.T. et al. Prognosis of patients with unilateral renal agenesis. Pediatr Nephrol 6, 412–416 (1992). https://doi.org/10.1007/BF00873996
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DOI: https://doi.org/10.1007/BF00873996