Pelvi-Ureteric Junction Obstruction in a Solitary Functioning Kidney in Children: An Unfavourable Combination.

IF 2.1 4区医学 Q1 PEDIATRICS

Acta Paediatrica Pub Date : 2025-09-23 DOI:10.1111/apa.70303

Mathilde Grapin, Lucas Rabaux, Mathilde Glenisson, Eva Mille, Nathalie Biebuyck, Evgenia Preka, Olivia Boyer, Kiarash Taghavi, Guillaume Dorval, Thomas Blanc

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引用次数: 0

Abstract

Aim: Solitary functioning kidney (SFK) is linked to chronic kidney disease (CKD) in children, particularly when associated with congenital anomalies of the kidney and urinary tract (CAKUT). Pelvi-ureteric junction obstruction (PUJO) is the most frequent obstructive uropathy in SFK. This study aimed to evaluate long-term kidney function in children operated on for PUJO in an SFK.

Methods: Among a retrospective cohort study of children with an SFK, a subgroup analysis was performed: primary SFK with operated PUJO (n = 35); primary SFK without CAKUT (n = 108); primary SFK with CAKUT other than PUJO (n = 24). Markers of CKD and measured glomerular filtration rate were assessed during follow-up.

Results: Surgery was indicated because of neonatal acute kidney injury (AKI) (n = 21), worsening renal pelvis dilation (n = 10). The median age at surgery was 15 months (1.2-30 months). At a median age of 13 years at last follow-up, the proportion of CKD was higher in primary SFK with PUJO compared to primary SFK without CAKUT (43% vs. 12%, p = 0.0008). In SFK/PUJO, neonatal AKI was predictive of subsequent CKD (OR 4.8, p = 0.04).

Conclusion: PUJO in an SFK is associated with a high rate of CKD during childhood, particularly when neonatal AKI is present.

查看原文本刊更多论文

肾盂-输尿管连接处梗阻在儿童单独功能肾脏：一个不利的组合。

目的：孤立功能肾（SFK）与儿童慢性肾脏疾病（CKD）有关，特别是当与肾脏和尿路先天性异常（ckut）相关时。肾盂输尿管交界处梗阻（PUJO）是SFK中最常见的梗阻性尿病。本研究旨在评估SFK中因PUJO手术的儿童的长期肾功能。方法：对SFK患儿进行回顾性队列研究，进行亚组分析：原发性SFK合并PUJO (n = 35)；无CAKUT的原发性SFK (n = 108)；除PUJO外，伴有CAKUT的主要SFK （n = 24）。随访期间评估CKD标志物和肾小球滤过率。结果：新生儿急性肾损伤（AKI）（n = 21），肾盂扩张加重（n = 10）需要手术。手术时中位年龄为15个月（1.2-30个月）。在最后一次随访的中位年龄为13岁时，合并PUJO的原发性SFK中CKD的比例高于未合并CAKUT的原发性SFK（43%对12%，p = 0.0008）。在SFK/PUJO中，新生儿AKI可预测随后的CKD （OR 4.8, p = 0.04）。结论：SFK的PUJO与儿童期CKD的高发率有关，特别是当新生儿存在AKI时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Paediatrica 医学-小儿科

CiteScore

6.50

自引率

5.30%

发文量

384

审稿时长

2-4 weeks

期刊介绍： Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including: neonatal medicine developmental medicine adolescent medicine child health and environment psychosomatic pediatrics child health in developing countries