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Renal function in congenital anomalies of the kidney and urinary tract
M J Kemper1, D E Müller-Wiefel
1Department of Pediatric Nephrology, University Children's Hospital, Zurich, Switzerland. Markus.Kemper@kispi.unizh.ch
Insights
Congenital kidney and urinary tract anomalies significantly impact children
Area of Science:
- Pediatric Nephrology
- Medical Genetics
- Congenital Abnormalities
Background:
- Congenital anomalies of the kidneys and urinary tract (CAKUT) are a leading cause of chronic and end-stage renal failure in children.
- Kidney function is largely determined by genetic factors early in development.
- Early assessment of kidney function is crucial for management and prognosis.
Purpose of the Study:
- To highlight the genetic basis of kidney function in congenital anomalies.
- To emphasize the importance of assessing kidney function in utero and postnatally.
- To discuss prognostic factors and their role in preserving kidney survival.
Main Methods:
- Assessment of kidney function, including absolute glomerular filtration rate (GFR).
- Evaluation of split and excretory renal function.
- Analysis of biochemical, molecular, and interventional prognostic factors.
Main Results:
- Kidney function is significantly influenced by genetic predispositions.
- In utero and postnatal assessments of renal function are clinically valuable.
- Various prognostic factors aid in preserving kidney survival.
Conclusions:
- Improved medical care offers encouraging outcomes for children with CAKUT.
- Understanding genetic influences and functional assessments guides treatment and prognosis.
- Minimizing modulating factors is key to long-term kidney health in affected children.
Abstract:
Congenital anomalies of the kidneys and urinary tract are a major cause of chronic and end-stage renal failure in children. The molecular mechanisms having been elaborated, there is now growing evidence that kidney function is to a large extent determined genetically at an early stage. Assessment of kidney function is an important tool in clinical medicine and is feasible in utero. Postnatally, determination of absolute glomerular filtration rate and also of split and excretory renal function play an important role in the determination of treatment and prognosis. This is supplemented by other biochemical, molecular and interventional prognostic factors, which are of help in preservation of kidney survival by minimizing modulating factors. If chronic or terminal renal failure ensues in childhood or even in early infancy, however, improved medical care has led to encouraging results, ultimately influencing the motivation in the care of children with congenital anomalies of the kidney and urinary tract.