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

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 characterizations. To evaluate the clinical presentations, complications, and management approaches of the radiologically diagnosed unilateral hypoplastic kidney. A retrospective review of the records of patients with a radiological diagnosis of unilateral hypoplastic kidney between July 2015 and June 2020 was done at Assiut Urology and Nephrology Hospital, Assiut University, Egypt. A total of 33 cases were diagnosed to have unilateral hypoplastic kidney with a mean (range) age of 39.5 ± 11.2 (19-73) years. The main clinical presentation was loin pain (51.5%), stone passer (9.1%), anuria (12.1%), accidental discovery (15.2%), or manifestations of urinary tract infections (12.1%). Computed tomography was the most useful tool for radiological diagnosis. However, radioisotope scanning could be requested for verification of surgical interventions and nephrectomy decisions. Urolithiasis occurred in 23 (69.7%) cases and pyuria was detected in 22 (66.7%) cases where the infection was documented by culture and sensitivity test in 19 cases. While the non-complicated cases were managed by assurance only (12.1%), nephrectomy (15.2%) was performed for persistent complications. However, symptomatic (27.3%) and endoscopic (45.6%) approaches were used for the management of correctable complications. Unilateral hypoplastic kidney in adults has various complications that range from urinary tract infections to death from septicemia. Diagnosis is mainly radiological and management is usually conservative or minimally invasive.