Indications and relative renal function for paediatric nephrectomy over a 20-year period.

Abstract

BACKGROUND:

The indications for partial or total nephrectomy for urological reasons are not clearly documented in the paediatric surgical literature and there are only a limited number of publications on this subject.

PURPOSE:

In order to clarify the situation in our centre, we reviewed our own indications for nephrectomy over a 20-year period.

METHODS:

Medical records of patients who underwent nephrectomy for urological and oncological causes between May 1990 and October 2010 at our centre were retrospectively reviewed. Indications for nephrectomy were noted. Renal function was noted for urological cases.

RESULTS:

A total of 357 nephrectomies were undertaken; out of these, 241 cases were for urological causes and 116 for oncological reasons. The majority of total nephrectomies were performed for multicystic dysplastic kidneys, reflux nephropathy, pelvi-ureteric junction obstruction and dysplasia. Eighty-seven patients exhibited no function at the time of nephrectomy. Of the remainder, 17 had <5% function, 18 had 5-10% function, 5 had 10-15% function and 2 patients had 15-20% function.

CONCLUSIONS:

This is the largest series of nephrectomies in the paediatric surgery literature to date. The majority of nephrectomies were undertaken for urological conditions with relative renal function of <10% and could not have been usefully preserved in situ. We suggest that kidneys with >10% function should not be routinely removed.

• Authors: Neil Featherstone, Su-Anna Boddy, Feilim Liam Murphy
• Journal: Pediatric surgery international (Pediatr Surg Int) Vol. 27 Issue 11 Pg. 1227-31 (Nov 2011) ISSN: 1437-9813 [Electronic] Germany
• PMID: 21953522 (Publication Type: Comparative Study, Journal Article)

Topics

• Adolescent
• Child
• Child, Preschool
• Female
• Follow-Up Studies
• Glomerular Filtration Rate (physiology)
• Humans
• Infant
• Infant, Newborn
• Kidney (physiopathology, surgery)
• Kidney Diseases (diagnosis, physiopathology, surgery)
• Male
• Nephrectomy (methods)
• Prognosis
• Retrospective Studies
• Severity of Illness Index
• Time Factors