Clinical Outcomes and Risk Factors in Pediatric Patients with Solitary Functioning Kidney: A Comparative Analysis of Congenital and Acquired Etiologies

Hülya Gözde Önal ^1* Yonca Semet ²

• ¹ Samsun Training and Research Hospital, Samsun, Türkiye
• ² Faculty of Medicine, Samsun University, Samsun, Samsun, Türkiye

Introduction: This study aims to assess the clinical outcomes and kidney function of pediatric patients with a solitary functioning kidney due to various causes. It focuses on glomerular filtration rate (GFR) across five groups: renal agenesis, multicystic dysplastic kidney (MCDK), atrophic kidney, hypoplastic kidney, and patients who underwent nephrectomy due to bleeding, stones, infection, or tumor without progressing to renal failure.Methods: The retrospective chart review was conducted on single kidneys of 396 patients seen in the pediatric nephrology clinic from January 2011 to June 2024. Descriptive statistics were used to summarize data, with chi-square tests employed for categorical variables and t-tests or Mann-Whitney U tests for continuous variables. For more than two groups, ANOVA or Kruskal-Wallis tests with post-hoc Bonferroni tests were performed.Results: Baseline and final GFR between the groups have shown significant differences in the pre and post-tests. MCDK group has significantly lower GFR compared to renal agenesis and remaining etiologies. Albumin levels were decreased in MCDK patients, whereas neutrophil levels were increased in the subject of the renal agenesis. Hypertension or proteinuric activity did not exhibit significant variation in frequency across these groups.Discussion: This study serves to point out the personalized management approach for pediatric patients with SFK, specifically those with MCDK who are more likely to lose early kidney function. Minimizing the risks and improving the outcome would require routine, topical course of monitoring along with treatment.