Clinico-Biochemical Profile of Children with Congenital Anomalies of the Kidney and Urinary Tract: A Cross-Sectional Study

Abstract

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are a group of disorders responsible for the majority of pediatric end-stage renal disease cases. There are only a few studies on CAKUT. Objectives: A study was conducted to determine the clinical and biochemical profile of children with CAKUT and to estimate the prevalence and the factors associated with hypertension in CAKUT. Methods: A cross-sectional study was conducted in a tertiary center for 18 months from March 2014 to August 2015. Demographic data were recorded, and clinical examination including blood pressure measurement was performed. Various biochemical parameters including plasma renin activity (PRA), urinary beta-2-microglobulin (B2M), and microalbuminuria were evaluated. Results: A total of 81 patients with CAKUT were studied. Twenty-two (27%) patients were underweight, 4 (5%) patients were stunted, and 26 (32%) were both underweight and stunted. Children with bilateral disease had a higher incidence of underweight (21/44 vs. 8/37; p = 0.04; 95% CI; Fisher exact test), and both underweight and stunted (25/44 vs. 10/37; p = 0.006; 95% CI; Fisher exact test) compared to children with unilateral disease. Hypertension was found in 27% cases. No association was found between hypertension and PRA, BM2, or microalbuminuria in our study. PRA was inversely proportional to the estimated glomerular filtration rate (eGFR) (Pearson test; 95% CI; p = 0.006). Conclusions: Bilateral disease in CAKUT was significantly associated with poor somatic growth. PRA was inversely proportional to eGFR. The prevalence of hypertension was higher in children with CAKUT than in normal children and is possibly multifactorial as it was not associated with elevated PRA, B2M, or microalbuminuria.

Clinical Characteristics of Congenital Anomalies of the Kidney and Urinary Tract, Minia District

“…This male predominance may be due to occurrence of some types of CAKUT exclusively in males e.g. PUV [2[8] Obstructive form of CAKUT detected in 73% of cases in this study where UPJO ranked the first among different CAKUT types up to 30% of cases the same finding reported by Aksu et al, (2005) and Radhakrishna et al, (2019) where PUJO was the most frequent type of CAKUT in both studies [9] [10] In contrast, Soliman et al, (2015) reported that…”

“…PUV was the commonest abnormality (36.4%) followed by VUR (19.6%) then PUJO (18.7%), but this difference may be attributed to different age group included in his study [2] . Unfortunately in this study, less than quarter of cases diagnosed early (21.3% antenatal and 34% early postnatal) which lower than Soliman et al, (2015) study (36.6% antenatal diagnosis) and much lower than what reported by Radhakrishna et al, (2019) in India (65% antenatal an 47% early postnatal) [2] [10] .…”

Changing pattern of renal disease in children at pediatric nephrology clinic of a tertiary teaching hospital, Nepal: 10-year review

“…Studies have found pelvic ureteric junction obstruction to be the most common form of CAKUT. 10,14 Other studies have reported nephrotic syndrome 8 being the most common diagnosis and acute glomerulonephritis 9 as the most common diagnosis.…”

“…Similar to other studies, there were more male children with renal diseases than female children. 2,5,[7][8][9][10][11] The most common renal diseases in our study were CAKUT. Most of the children with CAKUT had VUR, similar to other studies.…”

The Correlation of Congenital Anomalies of The Kidney and Urinary Tract with Renal Function in Children

“…Another study reported PUJO (62.7%) and VUR (16.6%). In a recent study from Radhakrishna et al, 2019, it was shown that although the majority of CAKUT has evidence of antenatal hydronephrosis, CAKUT sufferers begin to show symptoms of delayed presentation of various CAKUT, especially PUV and PUJO 8 .…”