From the Research
Patients with congenital solitary kidney should undergo regular monitoring, including annual blood pressure measurements, urinalysis for proteinuria, and renal function tests, as well as ultrasound evaluation at diagnosis and periodically thereafter to assess kidney size and detect complications. When managing a patient with congenital solitary kidney, several key considerations must be taken into account to preserve renal function and prevent long-term complications. The most recent and highest quality study on this topic is from 2022 1, which provides consensus recommendations for the management of congenital solitary kidney, emphasizing the importance of diagnostic approach, nutritional and lifestyle habits, and follow-up. Key aspects of management include:
- Regular monitoring of blood pressure, urinalysis, and renal function tests
- Ultrasound evaluation to assess kidney size and detect structural abnormalities
- Blood pressure control using ACE inhibitors or ARBs if hypertension develops, as these medications provide renoprotection
- Avoidance of nephrotoxic medications and maintenance of adequate hydration
- Prompt treatment of urinary tract infections and cautious approach to contact sports with high risk of kidney trauma
- Regular follow-up with a nephrologist, with frequency based on kidney function and complications Additionally, a study from 2018 2 highlights the importance of early proteinuria lowering by angiotensin-converting enzyme inhibition in predicting renal survival in children with chronic kidney disease, which can be applied to the management of congenital solitary kidney. Overall, the goal of management is to prevent long-term renal function decline and preserve kidney function, and regular monitoring and timely interventions are crucial in achieving this goal.