Children With Single Kidney Can Thrive Through Evidence-Based Care: Experts

New Delhi: Leading pediatric health experts, nephrologists, and surgeons across India are sharing a unified message of reassurance: children born with a single kidney — a condition known as unilateral renal agenesis (URA) — can live full, healthy, and active lives when provided with appropriate medical oversight, nutritional guidance, and supportive home and school environments.

According to global epidemiological data, approximately 1 in 1,000–2,000 babies are born with a solitary kidney. A 2023 meta-analysis covering more than 15.6 million individuals found renal agenesis occurs in 0.03% of births, with unilateral cases accounting for the majority. In many children, the functioning kidney naturally enlarges — a process called compensatory hypertrophy — allowing it to perform the work of two kidneys effectively.

“Parents often feel anxious when they learn their child has one kidney, but most of these children grow up without complications,” said Dr. Shandip Kumar Sinha, Director of Pediatric Surgery and Pediatric Urology at Medanta–The Medicity, Gurugram. “With routine monitoring and simple lifestyle precautions, they can enjoy a completely normal childhood.”

Strong Outcomes, With Evidence to Guide Care

Studies show that the long-term outlook for children with a solitary functioning kidney is overwhelmingly positive. A comprehensive systematic review analyzing 2,684 patients found that while some may develop proteinuria or elevated blood pressure, the vast majority maintain normal kidney function into adulthood (Source: PubMed, PMID: 23449343).

A recent study of 171 children with URA reported that:

• 2.3% developed proteinuria

• 10.5% had hypertension (including masked hypertension)

• 2.9% developed signs of chronic kidney disease (Source: PubMed, PMID: 33723672)

However, long-term follow-up research also shows that up to 94% of children remain free from kidney injury well into their teenage years (MDPI Diagnostics, 2025).

“These numbers reinforce that early awareness and regular check-ups make all the difference,” said Dr. Amit Agarwal, Pediatric Nephrologist at Rainbow Children’s Hospital. “A child with one kidney is not defined by limitations, but by resilience and the confidence we help them build.”

Lifestyle, Activity, and Emotional Well-Being

Experts emphasize that children with a single kidney do not require restrictive diets or overly cautious lifestyles. Most sports — including football, running, cycling, and swimming — are safe. Contact sports may require protective gear or individualized medical advice.

“Psychological and emotional support is equally important,” said Dr. Ankit Prasad, Senior Consultant and Unit Head, Fortis Hospital, Noida. “Counseling and educating peers can reduce stigma and prevent unnecessary bullying. Hydration, adequate sleep, low-sodium diets, routine physical activity, and regular blood pressure checks are essential.”

Dr. Ashish Gupta, Senior Consultant Pediatrician at Apollo Hospital, added:

“Unilateral kidney agenesis often goes unnoticed for years and is discovered incidentally. Parents should not panic — routine urine protein checks, BP monitoring, and occasional ultrasound are usually all that’s needed. What we must avoid are dangerous contact sports, excess salt, and kidney-toxic medications.”

Why Early Screening Matters

Due to advancements in prenatal imaging, many cases of URA are now detected before birth, enabling timely planning and counseling. Pediatric societies such as the Indian Society of Pediatric Nephrology (ISPN) are calling for broader awareness campaigns so families understand the importance of long-term monitoring.

Global health organizations also stress that solitary kidneys typically function normally and support a high quality of life — provided blood pressure and proteinuria are monitored over time.

A Message of Hope

“Parents need reassurance, not fear,” said Dr. Sinha. “With regular care — especially annual BP checks and urine tests — these children can absolutely lead normal, healthy, and fulfilling lives.”

As India continues strengthening pediatric kidney care awareness and monitoring, experts agree on one message: a single kidney is not a limitation but a manageable medical condition — and with the right support, children can thrive.