Unilateral or bilateral early nephrectomy in infants with autosomal recessive polycystic kidney disease? Weighing risks and benefits

We read with great interest the article by Overman RE and colleagues [1] describing their experience in performing early nephrectomies in neonates with symptomatic autosomal recessive polycystic kidney disease (ARPKD) diagnosed prenatally or at birth. The authors compared two series of patients undergoing initial unilateral or concomitant bilateral nephrectomy, and evaluated early outcomes relative to the type of initial operation performed. In the overall cohort of patients, they did not find any difference in the duration of mechanical ventilation or days to peritoneal dialysis (PD) catheter use between the two operative approaches, when full feeds were attained, and in the mortality rate within the first year of life.