Development and autoregulation of kidney function in children: a retrospective study using .sup.99mTc-MAG3 renography

Background Both the development of kidney function in healthy children and autoregulation ability of kidney function in patients with asymmetric kidneys are important in clinical diagnosis and treatment of kidney-related diseases, but there are however only limited studies. This study aimed to inves...

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Published in:Pediatric nephrology (Berlin, West) West), 2022-09, Vol.37 (9), p.2157
Main Authors: Cao, Xinhua, Xu, Xiaoyin, Treves, S. Ted, Drubach, Laura A, Kwatra, Neha, Zhang, Min, Fahey, Frederic H
Format: Article
Language:English
Subjects:
Demographic aspects
Diagnosis
Isotopes
Kidney diseases
Kidney function tests
Risk factors
Technetium
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Summary:Background Both the development of kidney function in healthy children and autoregulation ability of kidney function in patients with asymmetric kidneys are important in clinical diagnosis and treatment of kidney-related diseases, but there are however only limited studies. This study aimed to investigate development of kidney function in normal children with healthy symmetric kidneys and autoregulation of the healthy kidney compensating the functional loss of a diseased one in children with asymmetric kidneys. Methods Two hundred thirty-seven children (156 male, 81 female) from 0 to 20y (average 4.6y ± 5.1) undergoing .sup.99mTc-MAG3 renography were included, comprising 134 with healthy symmetrically functioning kidneys and 103 with asymmetric kidneys. Clearance was calculated from kidney uptakes at 1-2 min. A developmental model between MAG3 clearance (CL) and patient age in normal group was identified (CL = 84.39Age.sup.0.395 ml/min, r = 0.957, p < 0.001). The clearance autoregulation rate in abnormal group with asymmetric kidneys was defined as the ratio of the measured MAG3 clearance and the normal value predicted from the renal developmental model of normal group. Results No significant difference of MAG3 clearance (p = 0.723) was found between independent abnormal group and normal group. The autoregulation rate of kidney clearance in abnormal group was 94.2% on average, and no significant differences were found between two age groups (p = 0.49), male and female (p = 0.39), and left kidney and right kidney (p = 0.92) but two different grades of asymmetric kidneys (p = 0.02). Conclusions The healthy kidney of two asymmetric kidneys can automatically regulate total kidney function up to 94% of two symmetric kidneys in normal children. Graphical abstract
ISSN:0931-041X
DOI:10.1007/s00467-022-05446-z