Medium-Term Follow-Up of Children with Unilateral Non or Poorly Functioning Kidney: A Single-Center Experience

Purpose: The aim of the study was to assess the safety of conservative management of nonfunctioning kidney in children. Material and Methods: The study group consisted of 29 children with a unilateral or poorly functioning kidney who were followed at the outpatient clinic of the Urology Unit of a tertiary pediatric medical center for at least two years. Pain, hypertension, urinary tract infection, and renal calculi were assessed regularly during follow up. Results: Mean duration of follow-up was 62 months. The main causes for non-functioning kidney were high grade vesicoureteral reflux (55%) and ureteropelvic junction obstruction (34%). Urinary tract infection (24%) occurred mostly during the first 18 months of follow up. UTI was observed in all children who had bilateral vesicoureteral reflux or an ectopic ureter. None of the children developed pain, hypertension or renal calculi during follow-up period. Conclusions: In children, preserving a nonfunctioning kidney due to causes other than vesicoureteral reflux does not increase the risk of complications on medium term follow up. Those with non-functioning kidney due to high grade vesicoureteral reflux should be offered nephrectomy to decrease the risk of UTI.