TY - JOUR
T1 - Uncovering risk factors for kidney injury in children with a solitary functioning kidney
AU - Solitary Functioning Kidney: Aetiology and Prognosis (SOFIA) study group
AU - Groen in ‘t Woud, S.
AU - Roeleveld, Nel
AU - Westland, R.
AU - Renkema, Kirsten Y.
AU - Steffens, Martijn G.
AU - Gracchi, Valentina
AU - Lilien, Marc R.
AU - van Wijk, Joanna A.E.
AU - Feitz, Wout F.J.
AU - Schreuder, Michiel F.
AU - van der Zanden, Loes F.M.
AU - Beeren, M. C.G.
AU - Blokland-Loggers, H. E.
AU - Breukels, M.
AU - van den Broek, L. M.
AU - del Canho, R.
AU - Creemers, D.
AU - van Dael, C. M.L.
AU - van der Deure, H.
AU - Dings-Lammertink, A.
AU - Dorrepaal, C.
AU - Dorresteijn, E.
AU - Feitz, W. F.J.
AU - Groen in ‘t Woud, S.
AU - Harnisch, E.
AU - Jacobs, M. J.
AU - Jira, P. E.
AU - Keijzer-Veen, M. G.
AU - Kloosterman, F. J.
AU - Knots, E.
AU - Konijnenberg, A. Y.
AU - Koppejan-Stapel, M.
AU - van der Kuur, E. C.
AU - van Ledden-Klok, M. J.
AU - Leunissen, R. W.J.
AU - Lilien, M. R.
AU - Jansen, C. Meine
AU - de Moor, R.
AU - Nijhuis, I. J.M.
AU - Pierik, L. J.W.M.
AU - Pijning, A.
AU - de Pont, S. M.H.B.
AU - Renkema, K. Y.
AU - Rijlaarsdam, R.
AU - Roeleveld, N.
AU - Schreuder, M. F.
AU - Tanja, A. L.
AU - van Wijk, J. A.E.
AU - van der Zanden, L. F.M.
N1 - Funding Information:
This research was funded by a Junior Investigator Grant from the Radboud Institute for Health Sciences. LFMvdZ is funded by a Veni grant (91618036) from the Dutch Research Council. MFS is funded by a Vidi grant (016.156.454) from the Dutch Research Council. We would like to thank all pediatricians, pediatric nephrologists, urologists, and other colleagues who helped with the identification of patients and collection of data. Furthermore, we are grateful to all patients and their parents for their willingness to participate. The following physicians are included as nonauthor collaborators in the Solitary Functioning Kidney: Aetiology and Prognosis (SOFIA) study group: F.J. Kloosterman (Isala Klinieken), M.G. Keijzer-Veen (Wilhelmina Children's Hospital, University Medical Center Utrecht), B. Zegers (Máxima Medical Center), P.E. Jira (Jeroen Bosch Ziekenhuis), H. van der Deure (Deventer Ziekenhuis), R.W.G. van Rooij (Leiden University Medical Center Willem Alexander Children's Hospital), E. Wijnands–van den Berg (Medisch Spectrum Twente [currently Isala Klinieken]), M. Breukels (Elkerliek Ziekenhuis), S.M.H.B. de Pont (Amphia Ziekenhuis), E. Harnisch (Franciscus Gasthuis and Vlietland), C.M.L. van Dael (VieCuri/Maastricht UMC+), D. Creemers (Rijnstate [currently Deventer Ziekenhuis]), R. de Moor (Elisabeth-TweeSteden Ziekenhuis), A.Y. Konijnenberg (Ziekenhuis St Jansdal), E. Knots (Catharina Ziekenhuis Eindhoven), E.C. van der Kuur (Streekziekenhuis Koningin Beatrix), M.J. Jacobs (Maasziekenhuis Pantein), M. Koppejan-Stapel (Ziekenhuis Gelderse Vallei), A. Pijning (Slingeland Ziekenhuis), E. Dorresteijn (Erasmus Medical Center-Sophia Children's Hospital), R.W.J. Leunissen (Haaglanden Medisch Centrum), R. Rijlaarsdam (Ziekenhuisgroep Twente), R. del Canho (Maasstad Ziekenhuis), B. Semmekrot (Canisius Wilhelmina Ziekenhuis), A. Dings-Lammertink (Gelre Ziekenhuizen Loc Zutphen), I.J.M. Nijhuis (Wilhelmina Ziekenhuis Assen), M.J. van Ledden-Klok (Van Weel-Bethesda), L.M. van den Broek (St Jans Gasthuis), C. Meine Jansen (Groene Hart Ziekenhuis), M.C.G. Beeren (St Anna Zorggroep), H.E. Blokland-Loggers and C. Dorrepaal (St Antonius Ziekenhuis), L.J.W.M. Pierik (Ommelander Ziekenhuis Groningen), and A.L. Tanja (Martini ziekenhuis)
Funding Information:
This research was funded by a Junior Investigator Grant from the Radboud Institute for Health Sciences. LFMvdZ is funded by a Veni grant (91618036) from the Dutch Research Council. MFS is funded by a Vidi grant (016.156.454) from the Dutch Research Council.
Publisher Copyright:
© 2022 International Society of Nephrology
PY - 2023/1
Y1 - 2023/1
N2 - Children with a solitary functioning kidney (SFK) have an increased risk of kidney injury. The exact risk of and risk factors for kidney injury remain unknown, which impedes personalized care. Here, we recruited a nationwide multicenter cohort of 944 patients with SFK to get more insight into this by consenting patients born in 1993-2020 and diagnosed with congenital or acquired SFK before adulthood. The median follow-up was 12.8 years and four indications of kidney injury were studied: urine protein-creatinine ratios, blood pressure, estimated glomerular filtration rate and use of anti-hypertensive/proteinuric medication. For each indicator except medication use, separate cut-off values for any injury and severe injury were used. Survival analyses indicated that at 18 years of age, any or severe kidney injury were present in 75% and 39% of patients with congenital SFK, respectively. Risk factors for kidney injury included kidney agenesis as cause of the SFK, anomalies in the SFK, and high body mass index at last follow-up. Kidney agenesis and being overweight were specifically associated with proteinuria and high blood pressure, whereas anomalies in the SFK were associated with reduced estimated glomerular filtration rates. The high prevalence of kidney injury in patients with SFK emphasizes the need for long-term follow-up, in which lifestyle is an important topic to address. More research into the etiological role of risk factors will help to translate our findings into individualized care strategies. Thus, our study shows that a significant proportion of children with SFK will develop kidney injury over time.
AB - Children with a solitary functioning kidney (SFK) have an increased risk of kidney injury. The exact risk of and risk factors for kidney injury remain unknown, which impedes personalized care. Here, we recruited a nationwide multicenter cohort of 944 patients with SFK to get more insight into this by consenting patients born in 1993-2020 and diagnosed with congenital or acquired SFK before adulthood. The median follow-up was 12.8 years and four indications of kidney injury were studied: urine protein-creatinine ratios, blood pressure, estimated glomerular filtration rate and use of anti-hypertensive/proteinuric medication. For each indicator except medication use, separate cut-off values for any injury and severe injury were used. Survival analyses indicated that at 18 years of age, any or severe kidney injury were present in 75% and 39% of patients with congenital SFK, respectively. Risk factors for kidney injury included kidney agenesis as cause of the SFK, anomalies in the SFK, and high body mass index at last follow-up. Kidney agenesis and being overweight were specifically associated with proteinuria and high blood pressure, whereas anomalies in the SFK were associated with reduced estimated glomerular filtration rates. The high prevalence of kidney injury in patients with SFK emphasizes the need for long-term follow-up, in which lifestyle is an important topic to address. More research into the etiological role of risk factors will help to translate our findings into individualized care strategies. Thus, our study shows that a significant proportion of children with SFK will develop kidney injury over time.
KW - chronic kidney disease
KW - congenital anomalies of the kidney and urinary tract
KW - glomerular filtration rate
KW - hypertension
KW - prognosis
KW - solitary functioning kidney
U2 - 10.1016/j.kint.2022.09.028
DO - 10.1016/j.kint.2022.09.028
M3 - Article
C2 - 36374825
AN - SCOPUS:85142392577
SN - 0085-2538
VL - 103
SP - 156
EP - 165
JO - Kidney International
JF - Kidney International
IS - 1
ER -