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Urological anomalies and chronic kidney disease in children with anorectal malformations

Indra Ganesan1, Shunmugam Rajah

  • 1Paediatric Nephrology Service, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 298090, Singapore. Indra.Ganesan@kkh.com.sg

Pediatric Nephrology (Berlin, Germany)
|March 3, 2012
PubMed

Insights

Children with anorectal malformations (ARM) have a 23% risk of urological anomalies. High ARM lesions, genital abnormalities, and cloacal anomalies predict these risks, with low rates of chronic kidney disease (CKD).

Area of Science:

  • Pediatric Surgery
  • Urology
  • Nephrology

Background:

  • Anorectal malformations (ARM) are congenital conditions that can be associated with other anomalies.
  • Urological anomalies and chronic kidney disease (CKD) are potential complications in children with ARM.
  • Understanding risk factors for these complications is crucial for early intervention and improved outcomes.

Purpose of the Study:

  • To identify predictors of urological anomalies in infants with ARM.
  • To describe the clinical features and incidence of CKD in children with ARM.
  • To assess the long-term renal outcomes in this patient population.

Main Methods:

  • Retrospective review of infants diagnosed with ARM who underwent surgical correction.
  • Data collected from 1986 to 2010 at Sabah Women and Children's Hospital, Malaysia.
  • Analysis of 122 children with complete data to identify risk factors and clinical characteristics.

Main Results:

  • Urological anomalies were present in 23% of children with ARM.
  • Significant predictors for urological anomalies included high ARM lesion, genital abnormality, and cloacal anomaly in girls.
  • Chronic kidney disease (CKD) was observed in 5.7% of cases, with end-stage renal failure in 0.8%.

Conclusions:

  • While urological anomalies are common in ARM, the overall incidence of CKD and end-stage renal disease is low.
  • Early identification of infants with ARM at risk for renal complications is vital for preserving renal function.
  • Risk stratification can guide closer monitoring and timely management of potential renal issues in children with ARM.
Abstract

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