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Published in: Pediatric Nephrology 9/2015

01-09-2015 | Original Article

The impact of small kidneys

Authors: Douglas G. Matsell, Dan Cojocaru, Eli W. Matsell, Allison A. Eddy

Published in: Pediatric Nephrology | Issue 9/2015

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Abstract

Background

Small kidneys due to renal hypodysplasia (RHD) result from a decrease in nephron number. The objectives of this study were to identify clinical variables that determine long-term renal outcome in children with RHD and to define the role of kidney size as a predictor of developing end-stage renal disease (ESRD).

Methods

This was a single-center retrospective cohort analysis. The primary outcome was development of ESRD. We identified 202 RHD cases, with 25 (12 %) reaching ESRD at mean age of 8.9 (±6.6) years.

Results

Children with RHD with a known genetic syndrome had the smallest kidneys while those with posterior urethral valves (PUV) had the largest kidneys at diagnosis. Cases with bilateral RHD were most likely to develop ESRD. Younger gestational age (OR 0.8, CI 0.69–0.99, p = 0.05), smaller kidney size at diagnosis (OR 0.13, CI 0.03–0.47, p = 0.002), lower best-estimated glomerular filtration rate (eGFR) (OR 0.74, CI 0.58–0.93, p = 0.01), proteinuria (OR 1.03, CI 1.01–1.05, p < 0.001) and high blood pressure (OR 1.02, CI 1.01–1.04, p = 0.01) were associated with development of ESRD, while kidney size at diagnosis was independently associated with ESRD (HR 0.03, CI 0.01–0.72, p = 0.043).

Conclusions

In children with RHD, kidney size at diagnosis predicts the likelihood of developing ESRD.
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Metadata
Title
The impact of small kidneys
Authors
Douglas G. Matsell
Dan Cojocaru
Eli W. Matsell
Allison A. Eddy
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 9/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-015-3079-5

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