1. Kidney length standardized to body length predicts outcome in infants with a solitary functioning kidney
- Author
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Matsell, Douglas G., Bao, Carol, White, Teagan Po, Chan, Ella, Matsell, Eli, Cojocaru, Dan, and Bajno, Lydia
- Subjects
Stature -- Health aspects -- Measurement ,Kidneys -- Measurement -- Health aspects ,Genitourinary organs -- Abnormalities ,Pediatric research ,Health - Abstract
Background Infants with a solitary functioning kidney (SFK) are at risk for chronic kidney injury (CKI). Lack of compensatory kidney growth (CKG) is associated with CKI, but measuring CKG is challenging since it is typically reported relative to normal kidneys. This study aims to (1) standardize SFK growth in infants, (2) investigate the relationship between standardized kidney length and clinical outcomes, and (3) use these results to develop a risk-based prediction model and local clinical pathway for SFK care. Methods This was a quality improvement study of 166 infants with an SFK. Linear regression was used to assess kidney growth from 0 to 180 days of life. Univariate binary regression analysis was used to identify kidney length to body length thresholds associated with the development of CKI, defined as the composite outcome of chronic kidney disease (eGFR < 60 mL/min/1.73 m.sup.2), hypertension, or proteinuria. Results Kidneys grew in length from 0 to 180 days, and growth was constant when standardized to body length. Over follow-up, infants with a baseline kidney length to body length [less than or equal to] 0.088 were more likely to experience CKI than the rest of the cohort (27 vs. 8%, p = 0.04). Kidney length to body length [less than or equal to] 0.088 was also significantly associated with CKI development (OR 4.17, 95% CI 1.14-15.28, p = 0.04). Conclusions In this study, kidney length to body length ratio was a stable CKG metric over 0-180 days, and a baseline ratio [less than or equal to] 0.088 was a risk factor for CKI. Results will aid in developing a practical, point-of-care risk assessment tool, and overarching risk-stratified clinical pathway for infants with an SFK. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information, Author(s): Douglas G. Matsell [sup.1] , Carol Bao [sup.1] , Teagan Po White [sup.1] , Ella Chan [sup.1] , Eli Matsell [sup.1] , Dan Cojocaru [sup.1] , Lydia Bajno [sup.2] [...]
- Published
- 2023
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