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Journal of the Korean Society of Pediatric Nephrology 2010;14(1): 42-50. doi: https://doi.org/10.3339/jkspn.2010.14.1.42
단일신을 가진 소아의 임상적 특징과 동반기형
김주휘, 이세은, 정윤혜, 한경희, 이현경, 강희경, 하일수, 정해일, 최용
1서울대학교 어린이병원 소아청소년과
2서울대학교 어린이병원 소아청소년과
3서울대학교 어린이병원 소아청소년과
4서울대학교 어린이병원 소아청소년과
5서울대학교 어린이병원 소아청소년과
6서울대학교 어린이병원 소아청소년과
7서울대학교 어린이병원 소아청소년과
8서울대학교 어린이병원 소아청소년과
9서울대학교 어린이병원 소아청소년과
Clinical Characteristics and Associated Anomalies in Children with Solitary Kidney
Joo-Whee Kim, Se-Eun Lee, Yun-Hye Jung, Kyung-Hee Han, Hyun-Kyung Lee, Hee-Gyung Kang, Il-Soo Ha, Hae-Il Cheong, Yong Choi
1Department of Pediatrics, Seoul National University Children's Hospital
2Department of Pediatrics, Seoul National University Children's Hospital
3Department of Pediatrics, Seoul National University Children's Hospital
4Department of Pediatrics, Seoul National University Children's Hospital
5Department of Pediatrics, Seoul National University Children's Hospital
6Department of Pediatrics, Seoul National University Children's Hospital
7Department of Pediatrics, Seoul National University Children's Hospital
8Department of Pediatrics, Seoul National University Children's Hospital
9Department of Pediatrics, Seoul National University Children's Hospital
Received: March 15, 2010;  Revised: March 24, 2010.  Accepted: March 29, 2010.
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ABSTRACT
Purpose : The clinical characteristics and associated anomalies in children with solitary kidney (SK) were analyzed retrospectively.
Methods : Total 38 children diagnosed to have SK at our hospital between December 1989 and December 2009 were recruited, and the clinical records including imaging studies were retrospectively reviewed. SK was defined as unilateral renal agenesis by imaging studies only, and patients with regression of unilateral dysplastic kidney were excluded.
Results : Among total 38 patients, 12 were male. The median age at the diagnosis of SK was 6.5 months (at birth-13 years). SK was detected by prenatal ultrasonography in 14 patients and during work-up for renal or urinary tract diseases in 13 (including urinary tract infection in 7). In 10 patients, SK was detected incidentally. Anomalies in the SK were noted in 17 patients including vesicoureteral reflux in 11. Other anomalies in the genitourinary tract were present in 16 patients, and multi-organ-involving syndromes or chromosomal anomalies were detected in 9. The mean duration of follow-up was 9 years (9 months-20 years). Two patients developed chronic renal failure during follow-up, and the median serum creatinine concentration of the remaining 36 at their last follow-up was 0.6 mg/dL.
Conclusion : SK may be isolated and clinically asymptomatic; it is frequently accompanied by other anomalies in genitourinary tract and other organs, some of which can induce progressive renal dysfunction. Early recognition of associated anomalies with SK and regular follow-up is recommended to reduce long-term risk.
Key words: Kidney disease | Urogenital abnormalities | Child | Retrospective studies
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