Renal outcome in adults with renal insufficiency and irregular asymmetric kidneys

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Renal outcome in adults with renal insufficiency and irregular asymmetric kidneys

Publisher
BioMed Central
Publication Date
Oct 05, 2004
Source
PMC
Keywords
Disciplines
  • Biology
  • Pharmacology
License
Unknown

Abstract

1471-2369-5-12.fm ral ss BioMed CentBMC Nephrology Open AcceResearch article Renal outcome in adults with renal insufficiency and irregular asymmetric kidneys Guy H Neild*1,2, Gill Thomson1, Dorothea Nitsch3, Robin G Woolfson2, John O Connolly2 and Christopher RJ Woodhouse1 Address: 1Institute of Urology and Nephrology, University College London, W1T 3AA, UK, 2Renal Unit, Middlesex Hospital (UCL Hospitals), Mortimer St., London, W1T 3AA, UK and 3Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel St., London, WC1E 7HT, UK Email: Guy H Neild* - [email protected]; Gill Thomson - [email protected]; Dorothea Nitsch - [email protected]; Robin G Woolfson - [email protected]; John O Connolly - [email protected]; Christopher RJ Woodhouse - [email protected] * Corresponding author Abstract Background: The commonest cause of end-stage renal failure (ESRF) in children and young adults is congenital malformation of the kidney and urinary tract. In this retrospective review, we examine whether progression to ESRF can be predicted and whether treatment with angiotensin converting enzyme inhibitors (ACEI) can delay or prevent this. Methods: We reviewed 78 patients with asymmetric irregular kidneys as a consequence of either primary vesico-ureteric reflux or renal dysplasia (Group 1, n = 44), or abnormal bladder function (Group 2, n = 34). Patients (median age 24 years) had an estimated GFR (eGFR) < 60 ml/min/1.73 m2 with at least 5 years of follow up (median 143 months). 48 patients received ACEI. We explored potential prognostic factors that affect the time to ESRF using Cox-regression analyses. Results: At start, mean (SE) creatinine was 189 (8) µmol/l, mean eGFR 41 (1) ml/min 1.73 m2, mean proteinuria 144 (14) mg/mmol creatinine (1.7 g/24 hrs). Of 78 patients, 36 (46%) developed ESRF, but none of 19 with proteinuria less than 50 mg/mmol and only two of 18 patients with eGFR above 50 ml/min di

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