A snapshot of children with congenital anomalies of the kidneys and urinary tract at three tertiary care centers of the armed forces

Abstract

Introduction: Congenital anomalies of Kidney and Urinary Tract (CAKUT) are the most common reason for Chronic Kidney Disease in children. The spectrum of CAKUT includes a wide range of anomalies from mild unilateral hydronephrosis to bilateral hypoplastic /dysplastic kidneys. We designed this study with an aim to determine the clinical profile of children with CAKUT, any associated anomalies and the factors associated with poor outcomes. Methods: We reviewed the records of all children aged 0-14 years presenting with CAKUT at the pediatric nephrology OPD at three tertiary care centers of the Armed Forces. Antenatal findings, clinical features at presentation, course after birth, need and timing for surgery, serum creatinine, presence of acidosis, mineral bone disease and anemia and growth parameters were recorded. All patients were evaluated and managed as per standard guidelines. Results: 154 children were seen during the study. Unilateral Hydronephrosis with mild to moderate PUJO was the commonest lesion, (n=35). Conclusions: Children with CAKUT have variable clinical presentations and outcomes depending on the severity of the underlying anomalies. Timely detection, evaluation and long term follow up is therefore essential for improving long term outcomes.

Keywords

• chronic kidney disease
• congenital anomalies of the kidneys and urinary tract
• end-stage renal disease