Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Jan 25, 2022; 11(1): 30-38
Published online Jan 25, 2022. doi: 10.5527/wjn.v11.i1.30
Unilateral hypoplastic kidney in adults: An experience of a tertiary-level urology center
Rabea Ahmed Gadelkareem, Nasreldin Mohammed
Rabea Ahmed Gadelkareem, Nasreldin Mohammed, Department of Urology, Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Assiut 71515, Egypt
Author contributions: Gadelkareem RA designed the research, searched and collected the data, and wrote the paper; Mohammed N contributed to study design and manuscript writing and revision, and supervised the work; both authors approved the paper.
Institutional review board statement: This study was approved on November 25, 2021 by the Medical Ethics Committee of the Faculty of Medicine, Assiut University, Egypt as a topic in a research project titled "Experience of a tertiary-level urology center in the clinical urological events of rare and very rare incidence: a retrospective research project." The institutional review board number is 17300684.
Informed consent statement: This article is a retrospective one with only descriptive anonymous data. Patients were not required to give informed consent to the study because the manipulated data were anonymous and were obtained after each patient agreed to treatment by consent.
Conflict-of-interest statement: The authors have no financial relationships to disclose.
Data sharing statement: No additional data are available. All the processed data are included in the study.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rabea Ahmed Gadelkareem, MD, Associate Professor, Department of Urology, Assiut Urology and Nephrology Hospital, Faculty of Medicine, Assiut University, Elgamaa Street, Assiut 71515, Egypt. dr.rabeagad@yahoo.com
Received: March 26, 2021
Peer-review started: March 26, 2021
First decision: July 31, 2021
Revised: August 7, 2021
Accepted: December 21, 2021
Article in press: December 21, 2021
Published online: January 25, 2022
Processing time: 299 Days and 12.2 Hours
ARTICLE HIGHLIGHTS
Research background

Unilateral small-sized kidney is a radiological term referring to both the congenital and acquired causes of reduced kidney volume. However, the hypoplastic kidney may have peculiar clinical and radiological characteristics. Its symptomatic clinical presentations are mostly attributed to the occurrence of underlying complications warranting early and proper management.

Research motivation

There is a noticeable lack of research on the clinical aspects of the unilateral hypoplastic kidney in the updated literature. Presentation of the current series may help enrich the literature and enhance the practice.

Research objectives

To study the clinical characteristics, complications, and management approaches of the unilateral radiologically diagnosed hypoplastic kidney in adults.

Research methods

A retrospective study was carried out on patients with a radiological diagnosis of unilateral hypoplastic kidney between July 2015 and June 2020 at a tertiary-level urology center in Egypt. The demographic, clinical, and radiological characteristics and management approaches were reviewed.

Research results

The study included 33 cases with unilateral hypoplastic kidney with a mean (range) age of 39.5 ± 11.2 (19-73) years. Loin pain (51.5%) was the main clinical presentation followed by the accidental discovery (15.2%), anuria (12.1%), manifestations of urinary tract infections (UTIs; 12.1%), and stone passer (9.1%). Radiological diagnosis was commonly done by CT showing the main features including the small volume and the preserved smooth outline and structures. Urolithiasis occurred in 23 (69.7%) cases and pyuria was detected in 22 (66.7%) cases where UTIs were documented by culture and sensitivity test in 19 cases. The non-complicated cases were managed by assurance only (12.1%), symptomatic (27.3%) and endoscopic (45.6%) approaches were used for the management of simple and correctable complications, and nephrectomy (15.2%) was performed for persistent complications.

Research conclusions

There are various presentations for the unilateral hypoplastic kidney ranging from accidental discovery to UTIs that may lead to death by septicemia. The diagnosis is mainly radiological and management is usually conservative or minimally invasive relative to the underlying findings.

Research perspectives

Presentation of the clinical characteristics and outcomes may enhance the relevant urological practice of this disease. Urologists can provide the proper management including the conservative approaches for the simple complications and laparoscopic nephrectomy for the persistent complications.