Natural Course of Children With Dysplastic and Hypoplastic Kidney

Abstract

Background: The objective of this study was to report the outcomes of children with dysplastic kidney and identify the variables that are independent predictors on the renal involution.

Methods: We reviewed the clinical, radiological, and nuclear medicine findings of 48 children (30 boys and 18 girls) with dysplastic or hypodisplastic kidney who were diagnosed and treated in our center between 1999 and 2012.

Results: A total of 25 cases (52%) were diagnosed prenatally and 23 (48%) postnatally. Twenty-six cases (54.1%) had pathologic findings in the contralateral kidney. During the follow-up, 21 patients (43.7%) showed completely involution within 2 years and 16 (33.3%) showed a partial involution. The univariate analysis showed that no variables were associated with complete involution. On laboratory evaluation, the mean creatinine level was 1.66 2.1 mg/dL and the mean estimated glomerular filtration rate (eGFR) was 75.8 55.6 mL/min. Eleven patients (22.9%) had an eGFR < 30 mL/min/1.73 m², of which 7 had contralateral renal dysplasia and 4 had contralateral reflux nephropathy. Nevertheless, at last follow-up, 18 children were in end-stage renal failure (37.5%). Proteinuria was noted in 11(22.9%) patients, of whom all had nephrotic range proteinuria. Fifteen (31.2%) cases had hypertension at diagnosis but no children developed new onset hypertension during the follow-up. Furthermore, no neoplastic degeneration was documented in any case.

Conclusions: The prognosis of dysplastic kidneys depends on the function of the contralateral kidney, so these patients should be monitored regularly assessing the dysplastic and contralateral kidney, blood pressure, urinalysis, and renal function.




World J Nephrol Urol. 2013;2(2):55-59
doi: http://dx.doi.org/10.4021/wjnu122w