Introduction 1 3 4 5 6 7 10 11 8 5 12 13 11 14 16 17 20 21 Materials and methods n n n 1 Table 1 Demographic data, anthropometric data, and renal functional parameters of the patients and control groups Parameters n n n n Gender (M/F) 11/11 12/10 10/12 10/12 Age (years) 8.63 ± 4.50 8.03 ± 4.30 8.31 ± 4.04 8.78 ± 3.49 Weight (kg) 28.44 ± 18.07 27.01 ± 17.14 26.57 ± 10.48 29.19 ± 10.92 Height (cm) 124.55 ± 27.62 126.05 ± 25.22 123.96 ± 21.21 128.36 ± 26.44 2 16.60 ± 2.95 17.96 ± 3.14 16.77 ± 2.05 16.96 ± 1.91 UMA (mg/L) 5.46 ± 3.91 4.80 ± 2.03 4.56 ± 8.11 5.18 ± 4.09 UMA/UCr (mg/mg) 0.23 ± 0.72 0.17 ± 0.30 0.07 ± 0.13 0.06 ± 0.06 2 1 121.95 ± 34.19 123.66 ± 43.67 108.57 ± 26.71 155.85 ± 41.27 2 0.59 ± 0.13 0.60 ± 0.15 0.65 ± 0.10 0.47 ± 0.13 Renal size (mm) 100.32 ± 18.42 91.32 ± 17.56 97.23 ± 17.49 92.36 ± 16.00 Values are expressed as mean±SD, M: male, F: female, BMI: body mass index, UMA: urine microalbumin, UCr: urine creatinine, GFR: glomerular filtration rate 1 p 2 p Both renal agenesis and atrophic kidney were established through renal ultrasound and scintigraphy. A non-functioning kidney is caused due to unilateral vesicoureteral reflux (in seven cases), ureteropelvic junction obstruction (in 10 cases), and multicystic dysplastic kidney (in five cases) in the UAK group. In contrast, indications for nephrectomy contained unilateral Wilms’ tumor (in six cases), a non-functioning kidney is caused due to unilateral vesicoureteral reflux (in 10 cases) and ureteropelvic junction stenosis (in two cases), multicystic dysplastic kidney (in two cases), and nephrolithiasis (in two cases) in the UNP group. Patients with Wilms’ tumor have favorable type and they did not receive chemotherapy. The mean time due to nephrectomy was 4.06 ± 3.87 years (range 0.5–17 years) in this group. 2 22 23 23 24 24 25 26 p Results 1 p p p p p p p 2 p p p p p p Table 2 Average pulse rate and blood pressure (BP) of the patients and the control groups Parameters n n n n Av. 24-h HR (beats/min) 89.36 ± 15.79 94.64 ± 17.74 88.18 ± 12.95 90.82 ± 14.79 Av. daytime HR (beats/min) 92.64 ± 15.51 97.14 ± 17.27 93.09 ± 12.96 97.41 ± 15.55 Av. night-time HR (beats/min) 80.23 ± 15.99 86.46 ± 18.01 77.86 ± 12.43 82.50 ± 16.65 Av. office SBP (mmHg) 113.96 ± 16.00 116.96 ± 11.24 114.55 ± 14.83 114.68 ± 12.66 Av. office DBP (mmHg) 74.73 ± 10.48 71.50 ± 11.06 71.05 ± 13.00 72.00 ± 9.67 Av. 24-h MAP (mmHg) 80.00 ± 7.92 78.82 ± 7.16 78.41 ± 7.06 78.27 ± 3.89 Av. 24-h SBP (mmHg) 106.64 ± 10.87 105.59 ± 9.31 104.22 ± 8.04 105.05 ± 6.90 1 65.91 ± 6.82 64.55 ± 6.59 64.09 ± 6.87 63.41 ± 3.63 Av. daytime MAP (mmHg) 81.14 ± 9.14 80.00 ± 8.04 79.68 ± 7.33 80.68 ± 4.86 Av. daytime SBP (mmHg) 109.59 ± 11.75 107.18 ± 10.01 106.55 ± 7.95 108.14 ± 6.83 Av. daytime DBP (mmHg) 68.36 ± 8.36 66.46 ± 7.17 66.18 ± 7.28 67.41 ± 4.36 Av. night-time MAP (mmHg) 72.86 ± 6.55 71.86 ± 7.70 72.09 ± 6.76 73.64 ± 4.99 Av. night-time SBP (mmHg) 99.82 ± 9.36 99.32 ± 9.99 99.00 ± 7.78 98.55 ± 6.60 Av. night-time DBP (mmHg) 59.00 ± 5.46 58.23 ± 7.18 58.09 ± 6.73 57.59 ± 3.75 Av. SBP dipping (%) 8.26 ± 4.29 7.31 ± 4.68 6.58 ± 3.42 8.83 ± 3.74 Av. DBP dipping (%) 13.12 ± 6.54 12.24 ± 7.64 12.03 ± 7.19 14.87 ± 6.32 Av. 24-h SBP load (%) 19.71 ± 25.75 26.31 ± 25.14 21.88 ± 20.08 14.45 ± 13.81 2 21.22 ± 17.12 33.0.2 ± 28.99 26.24 ± 24.56 13.54 ± 13.75 Values are expressed as mean±SD, Av.: average, HR: heart rate, MAP: mean arterial pressure, SBP: systolic blood pressure, DBP: diastolic blood pressure 1 p 2 p 3 Table 3 Some characteristics of the patients with unilateral functioning solitary kidney (USFK) according the percentile of renal size Parameters n n p Age (year) 5.91 ± 3.16 9.99 ± 4.09 <0.001 Height (cm) 113.19 ± 21.24 132.92 ± 23.47 <0.001 Weight (kg) 19.80 ± 9.89 32.56 ± 16.41 <0.001 Renal size (mm) 80.37 ± 11.13 107.31 ± 12.71 <0.001 2 107.82 ± 37.31 125.15 ± 33.09 <0.05 Av. 24-h HR (beat/min) 99.19 ± 15.49 84.87 ± 12.96 <0.001 Av. daytime HR (beat/min) 102.00 ± 13.81 88.95 ± 13.99 <0.001 Av. night-time HR (beat/min) 88.59 ± 17.05 76.62 ± 13.02 <0.05 Values are expressed as mean±SD, Av.: average, GFR: glomerular filtration rate, HR: heart rate 4 Table 4 Correlation between renal size standard deviation scores (SDS) and some parameters SDS in patients with UFSK and the controls Groups Parameters r p n Av. 24-h MAP SDS −0.284 0.021 Av. 24-h SBP SDS −0.175 0.159 Av. 24-h DBP SDS −0.034 0.788 Av. 24-h SBP load SDS −0.372 0.002 Av. 24-h DBP load SDS −0.295 0.016 n Av. 24-h MAP SDS −0.011 0.962 Av. 24-h SBP SDS −0.067 0.767 Av. 24-h DBP SDS −0.312 0.158 Av. 24-h SBP load SDS −0.148 0.510 Av. 24-h DBP load SDS −0.019 0.934 SDS: standard deviation scores, Av.: average, MAP: mean arterial pressure, SBP: systolic blood pressure, DBP: diastolic blood pressure Discussion 27 28 29 In our study, subjects were screened with urine microalbumin, urine and serum creatinine, GFR, and urine microalbumin-to-creatinine ratios in first-morning urine for the detection of proteinuria and renal functions. No statistically significant difference was found between the urine microalbumin and microalbumin-to-creatinine ratios in the first-morning urine in all of the patient and control groups. However, the GFR was lower and the serum creatinine level was higher in the subgroups of patients than those of the control group. These results show that a mild renal dysfunction may be detected in patients with UFSK. 11 13 21 11 8 3 To this end, we conclude that subtle alterations of renal function might be already present in children with UFSK, while no obvious pathological findings were made for BP or urinary protein excretion in the early period. However, an increased BP load was seen in these patients (particularly in patients without compensatory hypertrophy). Nevertheless, this might not exclude an increased long-term risk for the development of hypertension or impaired renal function in this patient group. Because patients in the present study have a small sample and a shorter follow-up period, further prospective studies with a larger sample size and of longer term are suggested to find the relationship between these parameters.