Retrospective evaluation of children with unilateral renal agenesis

Background Children born with unilateral renal agenesis (URA) are thought to have a risk of developing hypertension, proteinuria, and progressive chronic kidney disease (CKD). The present study aimed to evaluate the long-term prognosis and clinical characteristics of children with URA. Methods The study included 171 patients aged < 18 years diagnosed as URA who were followed-up for >= 1 year and 121 healthy controls matched for age, gender, and BMI. Results Median age at diagnosis was 2 years (IQR: 1 month-16 years) and the incidence of URA in males (65.4%) was higher than in females. Among the patients, 21 (12.2%) had other urinary system anomalies. It was noted that 2.3% of the patients had proteinuria, 15.2% had hyperfiltration, and 2.9% had CKD. Hypertension based on ambulatory blood pressure monitoring (ABPM) was diagnosed in 18 (10.5%) of the patients, of whom 10 had masked hypertension. Diastolic blood pressure in the URA patients was significantly higher than in the healthy controls. The incidence of hypertension and CKD was significantly higher in the patients with other urinary system anomalies. Conclusions Patients with a single functional kidney should be periodically evaluated throughout their lifetime for urine protein, blood pressure, and kidney functions. The most remarkable finding of this study is the importance of the use of ABPM for evaluating blood pressure in pediatric URA patients, especially for the detection of masked hypertension and the non-dipper phenomenon, which cannot be achieved with office blood pressure measurement.

Automated summary

This study evaluated the long-term prognosis and clinical characteristics of children with unilateral renal agenesis (URA), finding a higher incidence in males and a subset of patients with other urinary system anomalies. Proteinuria, hyperfiltration, hypertension, and CKD were observed in some patients, with higher incidence in those with other urinary system anomalies. The study highlights the importance of periodic evaluation for urine protein, blood pressure, and kidney functions in patients with a single functional kidney, as well as the use of ambulatory blood pressure monitoring for detecting masked hypertension.