Abstract: SA-OR44
Risk Factors for Kidney Injury in Children with Solitary Functioning Kidney
Session Information
- Assessing Disease Risk in Children: A Developmental Perspective
November 06, 2021 | Location: Simulive, Virtual Only
Abstract Time: 04:30 PM - 06:00 PM
Category: Pediatric Nephrology
- 1700 Pediatric Nephrology
Authors
- Groen in 't Woud, Sander, Radboudumc, Nijmegen, Gelderland, Netherlands
- Roeleveld, Nel, Radboudumc, Nijmegen, Gelderland, Netherlands
- Feitz, Wout, Radboudumc, Nijmegen, Gelderland, Netherlands
- Schreuder, Michiel F., Radboudumc, Nijmegen, Gelderland, Netherlands
- van der Zanden, Loes Fm, Radboudumc, Nijmegen, Gelderland, Netherlands
Group or Team Name
- SOFIA study group
Background
Patients with a solitary functioning kidney (SFK) are at increased risk of kidney injury, for which several risk factors have been suggested. Large differences exist between previously reported cohorts, which hampers translation of these findings into clinical care. Our objective was to investigate the risk of and risk factors for proteinuria, high blood pressure, a decreased glomerular filtration rate (GFR), or use of antihypertensive medication in our nationwide study of children with SFK.
Methods
Children with congenital and acquired SFK were recruited in >30 hospitals throughout The Netherlands. Information on risk factors for and signs of kidney injury were collected from electronic patient files. Kaplan-Meier curves were used to estimate survival without signs of kidney injury and Cox regression was used to evaluate risk factors.
Results
Of 982 patients who provided informed consent, detailed clinical information was available from 898 (91%). After a median follow-up duration of 9.7 years, proteinuria was present in 118 patients (15%), high blood pressure in 184 (22%), and a GFR <60 ml/min/1.73m2 in 23 (3.2%), while antihypertensive medication was used by 90 patients (9.8%). In total, 319 patients (36%) exhibited ≥1 sign of kidney injury and the median age at first sign of kidney injury was 4.4 year. Cumulative proportions of children with kidney injury were 20% at 5 years, 29% at 10 years, and 35% at 15 years of age. Kidney injury rates were higher in patients with a congenital cause of SFK compared to an acquired cause (odds ratio (OR) 1.6, 95% confidence interval (CI) 1.1-2.3), and in patients with unilateral renal agenesis compared to multicystic dysplastic kidney (OR 1.4, 95% CI 1.0-1.9).
Conclusion
Data from this largest SFK cohort so far indicate that one third of patients with SFK has one or more signs of kidney injury at 15 years of age. The cause of the SFK may influence the risk of kidney injury. Other risk factors will be investigated in our cohort to develop care strategies based on individual-patient risk profiles.