Journal of Health Sciences and Medicine

Abstract

Introduction: The prevalence of chronic kidney disease (CKD) is rapidly increasing worldwide. Solitary kidney is also increasing in ranking among the CKD etiologies, because there has been a rapid increase in the number of radical nephrectomies due to an increased number of renal transplantations from live donors and an increased number of patients with renal cell carcinoma. The aim of the current study is to identify risk factors that affect the glomerular filtration rate (GFR) in individuals with solitary kidney.
Material and Method: The current study included 204 patients (75 with congenital, 129 with acquired solitary kidney). Laboratory data during the first and last admissions were recorded. Patients divided into two groups according to annual decline of eGFR. Group I and II consisted of patients whose annual decline eGFR was more than 1ml/min/1.73 m2 and less than 1ml/min/1.73 m2, respectively. In addition, patients were divided into two groups as patients with congenital and acquired solitary kidney. The first control is the first examination in the nephrology outpatient clinic for congenital solitary kidney patient and the post-operative examination on the fourteenth day after discharge from the hospital for the acquired solitary kidney patient. The final control is the examination within the last three months before reaching the primary endpoint of the study.
Results: Of the patients, 36.8% were male, and the average age was 57.16±15.04 years. The duration of the follow-up period was 6.48±3.69 years. Group I had higher rates of diabetes mellitus, cardiovascular disease, older age, higher mean blood pressure(MBP), glucose, CRP, total cholesterol (TC), LDL-cholesterol, non-HDL-cholesterol, triglyceride/non-HDL-cholesterol ratio and lower albumin. In the group with acquired solitary kidney, the patients were older, the incidence of cardiovascular diseases was higher, and the eGFR at the first and last admission was lower. There was no difference between acquired SK and congenital SK in terms of annual change in eGFR. In regression analysis CRP, LDL-cholesterol, non-HDL-cholesterol, TG/non-HDL-cholesterol ratio are independent risk factors on annual decline of eGFR. Having a congenital or acquired single kidney had no effect on the annual decline of eGFR. In addition, TC, TC/HDL-cholesterol, triglyceride/non-HDL-cholesterol, triglyceride/HDL-cholesterol ratios, non-HDL -cholesterol correlated with CRP positively.
Conclusıon:Patients with solitary kidney have higher risk of developing CKD. Inflammation and dyslipidemia must be paid attention to protect eGFR. Besides the atherosclerosis in the microcirculation, dyslipidemia affect eGFR through inflammation. Having a congenital or acquired single kidney has no effect on the annual decline of eGFR.