Spectrum of congenital anomalies of the kidney and urinary tract in a pediatric nephrology clinic in Ethiopia and factors associated with advanced chronic kidney disease: A cross-sectional study.

Abstract

Chronic kidney disease (CKD) is a significant health concern for children with congenital anomalies of the kidney and urinary tract (CAKUT). To address the limited data on CKD prevalence and risk factors in Ethiopia, this study focuses on a specific cohort of CAKUT patients at the pediatric renal unit of Tikur Anbessa specialized hospital. We aim to determine the prevalence of CKD in Ethiopian CAKUT patients, identify independent predictors of advanced stage CKD, and explore the distribution of CKD among different CAKUT phenotypes. Medical charts of children with CAKUT who visited pediatric renal unit were reviewed. Logistic regression analyses were performed to determine the independent predictors of advanced CKD. Statistical significance was set at p ≤ 0.05.The study included 129 male subjects (70.9%). Only 25.3% of CAKUT cases were diagnosed prenatally. About 52.2% of patients had unilateral CAKUT. Posterior urethral valves (PUV) were the most commonly diagnosed CAKUT phenotypes (27.5%). Fifty-three (29.1%) of the patients had CKD, and stage 3 was the most diagnosed CKD (37.7%). CKD development was observed more frequently in patients with isolated PUV (39.6%). Factors like low birthweight, prematurity at birth, and the presence of bilateral CAKUT emerged as independent risk factors for developing advanced stage CKD. This study reveals a significant burden of CKD in children and adolescents with CAKUT. Despite its importance, prenatal CAKUT detection remains low. Posterior urethral valves are the most prevalent phenotype, associated with a higher risk of CKD. The research also highlights independent predictors for advanced CKD development.