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01-11-2019 | Educational Review

Towards adulthood with a solitary kidney

Authors: Pierre Cochat, Olivia Febvey, Justine Bacchetta, Etienne Bérard, Natalia Cabrera, Laurence Dubourg

Published in: Pediatric Nephrology | Issue 11/2019

Abstract

Around 1/1000 people have a solitary kidney. Congenital conditions mainly include multicystic dysplastic kidney and unilateral renal aplasia/agenesis; acquired conditions are secondary to nephrectomy performed because of urologic structural abnormalities, severe parenchymal infection, renal trauma, and renal or pararenal tumors. Children born with congenital solitary kidney have a better long-term glomerular filtration rate than those with solitary kidney secondary to nephrectomy later in life. Acute and chronic adaptation processes lead to hyperfiltration followed by fibrosis in the remnant kidney, with further risk of albuminuria, arterial hypertension, and impaired renal function. Protective measures rely on non-pharmacological renoprotection (controlled protein and sodium intake, avoidance/limitation of nephrotoxic agents, keeping normal body mass index, and limitation of tobacco exposure). Lifelong monitoring should include blood pressure and albuminuria assessment, completed by glomerular filtration rate (GFR) estimation in case of abnormal values. In the absence of additional risk factors to solitary kidney, such assessment can be proposed every 5 years. There is no current consensus for indication and timing of pharmacological intervention.

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Title: Towards adulthood with a solitary kidney
Authors: Pierre Cochat
Olivia Febvey
Justine Bacchetta
Etienne Bérard
Natalia Cabrera
Laurence Dubourg
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 11/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-018-4085-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Towards adulthood with a solitary kidney

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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