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Updated: Aug 30, 2026
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
Ultrasound screening for renal and urinary tract anomalies in healthy infants
Masami Tsuchiya1, Mari Hayashida, Takeshi Yanagihara
1Department of Pediatrics and Child Health, Nippon Medical School, Chiba, Japan. tsuchiya_masami/pediatrics@nms.ac.jp
Insights
Early infant ultrasound screening effectively detects congenital anomalies of the kidney and urinary tract (CAKUT), enabling timely treatment to prevent chronic renal failure. This method identified 3.5% of infants with CAKUT, allowing for crucial early interventions.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Congenital Abnormalities
Background:
- Congenital anomalies of the kidney and urinary tract (CAKUT) cause nearly 30% of childhood chronic renal failure in Japan.
- Current school-based urine screening targets glomerulonephritis but misses congenital anomalies.
- Early detection of CAKUT is crucial for preventing long-term renal dysfunction.
Purpose of the Study:
- To evaluate the efficacy of abdominal ultrasonography for early screening of CAKUT in 1-month-old infants.
- To determine the prevalence and types of renal and urinary tract anomalies detectable in early infancy.
Main Methods:
- Infants underwent abdominal ultrasonography at 1 month of age.
- Kidney characteristics (size, symmetry, position, echogenicity) and bladder/ureter abnormalities were assessed.
- Specific criteria for abnormalities included renal length, size difference, and central echo complex (CEC) separation (SFU grade ≥2).
Main Results:
- Screening of 5700 infants identified 198 cases (3.5%) of CAKUT.
- Abnormal CEC separation was the most common finding (approx. 60%), followed by abnormal renal size/asymmetry (30%).
- Specific diagnoses were made in 32 cases (0.6%), with obstructive uropathy being most prevalent (15 cases).
Conclusions:
- Abdominal ultrasonography is effective for the early detection of renal and urinary tract anomalies in infants.
- Early ultrasound screening facilitates timely treatment, potentially preventing the progression of renal dysfunction.
- This screening approach holds promise for improving long-term outcomes in children with CAKUT.
Background:
Nearly 30% of childhood cases of chronic renal failure in Japan are attributed to congenital anomalies of the kidney and urinary tract (CAKUT), and the number is increasing. Urine screening at school facilitates early diagnosis and treatment of glomerulonephritis, but early screening for anomalies is currently not in practice. The authors evaluated the value of early abdominal ultrasonography screening in 1-month-old infants.
Methods:
The following characteristics of kidneys were assessed: presence versus absence, size, symmetry of size, position, separation of the central echo complex (CEC), abnormal echogenicity, and other abnormal findings. The bladder and ureter were checked for abnormalities in bladder shape and wall, as well as retrovesical ureteral dilation. Criteria for abnormalities included kidney length of
Results:
Beginning in April 1994 and continuing until September 2001, screening of 5700 1-month-old infants yielded 198 positive cases (3.5%) of CAKUT. Most frequent was abnormal CEC separation (approximately 60% of all abnormalities), followed by abnormal renal size or size asymmetry (30%). Further investigation yielded a specific diagnosis in 32 cases (0.6%) of all subjects. Most prevalent was obstructive uropathy (15 cases); 8 children underwent surgery. Small kidneys and vesicoureteral reflux were next in frequency.
Conclusions:
Ultrasonograpy was effective for early detection of renal and urinary tract anomalies. Ultrasound screening in early infancy may permit early treatment, that can prevent renal dysfunction.
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