Management of the congenital solitary kidney: consensus recommendations of the Italian Society of Pediatric Nephrology.

Autor: La Scola C; Pediatric Nephrology and Dialysis, Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Massarenti 11, 40138, Bologna, Italy. claudio.lascola@aosp.bo.it., Ammenti A; Pediatric Multi-Specialistic Unit, Poliambulatorio Medi-Saluser, Parma, Italy., Bertulli C; Pediatric Nephrology and Dialysis, Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Massarenti 11, 40138, Bologna, Italy., Bodria M; Division of Nephrology, Dialysis, Transplantation, and Laboratory On Pathophysiology of Uremia, Istituto G. Gaslini, Genova, Italy., Brugnara M; Pediatria C, Ospedale Donna Bambino, Verona, Italy., Camilla R; Pediatric Nephrology Unit, Regina Margherita Department, Azienda Ospedaliero-Universitaria Città Della Salute E Della Scienza, Torino, Italy., Capone V; Pediatric Nephrology, Dialysis and Transplant Unit. Fondazione Ca' Granda IRCCS, Policlinico Di Milano, Milano, Italy., Casadio L; Unità Operativa Complessa Di Pediatria E Neonatologia, Ospedale Di Ravenna, AUSL Romagna, Ravenna, Italy., Chimenz R; Unità Operativa Di Nefrologia Pediatrica Con Dialisi, Azienda Ospedaliero-Universitaria G. Martino, Messina, Italy., Conte ML; Department of Pediatrics, Infermi Hospital, Rimini, Italy., Conversano E; Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy., Corrado C; Pediatric Nephrology, 'G. Di Cristina' Hospital, Palermo, Italy., Guarino S; Department of Woman, Child and of General and Specialized Surgery, Università Degli Studi Della Campania 'Luigi Vanvitelli, Napoli, Italy., Luongo I; Unità Operativa Complessa Di Nefrologia E Dialisi, AORN Santobono - Pausilipon, Napoli, Italy., Marsciani M; Unità Operativa Di Pediatria E Terapia Intensiva Neonatale-Pediatrica, Ospedale M Bufalini, Cesena, Italy., Marzuillo P; Department of Woman, Child and of General and Specialized Surgery, Università Degli Studi Della Campania 'Luigi Vanvitelli, Napoli, Italy., Meneghesso D; Unità Operativa Complessa Di Nefrologia Pediatrica - Dialisi E Trapianto, Dipartimento Di Salute Della Donna E del Bambino, Azienda Ospedaliero-Universitaria Di Padova, Padova, Italy., Pennesi M; Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy., Pugliese F; Pediatric Nephrology Unit, Department of Pediatrics, Marche Polytechnic University, Ancona, Italy., Pusceddu S; Pediatria AUSL, Imola, Italy., Ravaioli E; Department of Pediatrics, Infermi Hospital, Rimini, Italy., Taroni F; Pediatric Nephrology, Dialysis and Transplant Unit. Fondazione Ca' Granda IRCCS, Policlinico Di Milano, Milano, Italy., Vergine G; Department of Pediatrics, Infermi Hospital, Rimini, Italy., Peruzzi L; Pediatric Nephrology Unit, Regina Margherita Department, Azienda Ospedaliero-Universitaria Città Della Salute E Della Scienza, Torino, Italy., Montini G; Pediatric Nephrology, Dialysis and Transplant Unit. Fondazione Ca' Granda IRCCS, Policlinico Di Milano, Milano, Italy.; Giuliana and Bernardo Caprotti Chair of Pediatrics, Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy.
Jazyk: angličtina
Zdroj: Pediatric nephrology (Berlin, Germany) [Pediatr Nephrol] 2022 Sep; Vol. 37 (9), pp. 2185-2207. Date of Electronic Publication: 2022 Jun 17.
DOI: 10.1007/s00467-022-05528-y
Abstrakt: Background: In recent years, several studies have been published on the prognosis of children with congenital solitary kidney (CSK), with controversial results, and a worldwide consensus on management and follow-up is lacking. In this consensus statement, the Italian Society of Pediatric Nephrology summarizes the current knowledge on CSK and presents recommendations for its management, including diagnostic approach, nutritional and lifestyle habits, and follow-up. We recommend that any antenatal suspicion/diagnosis of CSK be confirmed by neonatal ultrasound (US), avoiding the routine use of further imaging if no other anomalies of kidney/urinary tract are detected. A CSK without additional abnormalities is expected to undergo compensatory enlargement, which should be assessed by US. We recommend that urinalysis, but not blood tests or genetic analysis, be routinely performed at diagnosis in infants and children showing compensatory enlargement of the CSK. Extrarenal malformations should be searched for, particularly genital tract malformations in females. An excessive protein and salt intake should be avoided, while sport participation should not be restricted. We recommend a lifelong follow-up, which should be tailored on risk stratification, as follows: low risk: CSK with compensatory enlargement, medium risk: CSK without compensatory enlargement and/or additional CAKUT, and high risk: decreased GFR and/or proteinuria, and/or hypertension. We recommend that in children at low-risk periodic US, urinalysis and BP measurement be performed; in those at medium risk, we recommend that serum creatinine also be measured; in high-risk children, the schedule has to be tailored according to kidney function and clinical data.
(© 2022. The Author(s).)
Databáze: MEDLINE
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