Unilateral hypoplastic kidney in adults: An experience of a tertiary-level urology center

Table 1 Demographic and clinical characteristics of the patients (n = 33), n (%)

Variable	Value
Age (yr)
Mean ± SD	39.5 ± 11.2
Median (range)	40 (19-73)
Gender
Male	19 (57.6)
Female	14 (42.4)
Main clinical presentations
Ipsilateral loin pain	8 (24.2)
Contralateral loin pain	4 (12.1)
Bilateral or vague abdominal pain	5 (15.2)
UTI manifestations	4 (12.1)
Stone passer ± LUTS or colic	3 (9.1)
Anuria/oliguria	4 (12.1)
Accidental discovery F1	5 (15.2)
Anatomical side
Right	23 (69.7)
Left	10 (30.3)
Laboratory investigations
Serum creatinine mean ± SD; median (range) (mg/dL)	1.2 ± 0.68; 0.9 (0.66-3.6)
Positive for protein in urine	5 (15.2)
Patients with WBCs > 10/HPF in urine F2	22 (66.7)
Patients with RBCs > 3/HPF in urine	15 (45.5)

¹F: Two cases of them were potential living donors and were excluded due to this anomaly and the other three cases were investigated for hypertension.

²F: In these cases, positive culture and sensitivity tests were reported in 19 cases (86.4%). HPF: High power field; LUTS: Lower urinary tract symptoms; RBCs: Red blood corpuscles; UTI: Urinary tract infection; WBCs: White blood cells.

Table 2 Number of patients and abnormal findings (other than small-sized kidney) per imaging tool, n (%)

Imaging modality	Number of patients who had this imaging	Abnormal findings	n (%)
US	33 (100)	Stones	19 (57.6)
		Cysts	3 (9.1)
		Hydronephrosis	7 (21.2)
KUB	33 (100)	Stones	18 (54.6)
IVU	2 (6.1)	Hydronephrosis	1 (3)
MSCT	27 (81.8)	Stones	23 (69.7)
		Cysts	3 (9.1)
		Hydronephrosis	8 (24.2)

IVU: Intravenous urography; KUB: Kidney-ureter-bladder radiography; MSCT: Multi-slice computed tomography; US: Ultrasonography.

Table 3 Total and split renal functions represented by the glomerular filtration rate in patients who were evaluated by renal isotope scanning (n = 8), n (%)

Case No.	Age (yr)	Gender	GFR (mL/min/1.73 m2)			Indication for isotope scanning
			Total	Right	Left
Case 1	25	Male	92.4	61.9 (67)	30.5 (33)	Kidney donation
Case 2	42	Female	83.2	53.4 (64.2)	29.8 (35.8)	Kidney donation
Case 3	47	Female	88.5	67.8 (76.6)	20.7 (23.4)	To verify decision
Case 4	45	Female	69.7	61.2 (87.8)	8.5 (12.2)	Patient request
Case 5	21	Female	86	16.8 (19.5)	69.2 (80.5)	Patient request
Case 6	37	Male	77.6	58.2 (75)	19.4 (25)	To verify decision
Case 7	28	Male	83.4	17.5 (21)	65.9 (79)	To verify decision
Case 8	26	Male	66.8	7.5 (11.2)	59.3 (88.8)	To verify decision

Table 4 Rates of complications that occurred in patients with unilateral hypoplastic kidney (n = 29/33), n (%)

Complication	Number of patients	Involvement/localization
		Ipsilateral	Contralateral	Bilateral/systemic
Urolithiasis	23 (69.7)	12 (36.4)	3 (9.1)	8 (24.2)
Renal cysts	3 (9.1)	2 (6.1)	1 (3)	0 (0)
Hydronephrosis	8 (24.2)	3 (9.1)	4 (12.1)	1 (3)
Recurrent UTI	10 (30.3)	1 (3)	2 (6.1)	7 (21.2)
Hypertension	3 (9.1)	NA	NA	3 (9.1)
Septicemia	1 (3)	0 (0)	1 (3)	1 (3)

NA: Not applicable; UTI: Urinary tract infection.

Table 5 Management approaches for patients with unilateral hypoplastic kidney (n = 33), n (%)

Approach of management	Category/variety	n (%)
Assurance only		4 (12.1)
Conservative/symptomatic treatment F1	Total number of patients who received the treatment F1	9 (27.3)
	For hypertension	2 (6.1)
	For UTI	3 (9.1)
	For stones	5 (15.2)
	Hydronephrosis	1 (3)
	For cysts	1 (3)
Shock wave lithotripsy		8 (24.2)
	Ipsilateral	2 (6.1)
	Contralateral	5 (15.2)
	Bilateral	1 (3)
Endoscopic procedures
	Ipsilateral ureteroscopy	3 (9.1)
	Contralateral ureteroscopy	3 (9.1)
	Contralateral JJ placement	5 (15.2)
Laparoscopic nephrectomy		5 (15.2)
	For recurrent UTI	2 (6.1)
	For hypertension	3 (9.1)
Open nephrectomy		1 (3)
	For stones	1 (3)

¹F: Many patients received conservative treatment for more than one element of complications, while others received it for certain complications and, at the same time, received surgical interventions for other complications. Also, some patients had failed conservative treatment before surgical interventions. JJ: Double-J ureteral stent; UTI: Urinary tract infection.