Related Experiment Video
Updated: Jan 28, 2026
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Clinical Profile and Outcome of Children with Congenital Obstructive Uropathy
Susmitha Tangirala1, Nalini Bhaskaranand1, Pushpa G Kini1
1Department of Pediatrics, Kasturba Hospital, Manipal, Karnataka, India.
Insights
Congenital obstructive uropathy in children can lead to chronic kidney disease (CKD). Hypertension and frequent urinary tract infections (UTI) are key predictors of CKD progression, impacting renal function and growth.
Area of Science:
- Pediatric Nephrology
- Urology
- Public Health
Background:
- Congenital obstructive uropathy (COU) is a significant cause of kidney disease in children.
- Early diagnosis and management are crucial for preserving renal function and preventing long-term complications.
- Understanding the risk factors for chronic kidney disease (CKD) progression in COU is essential for improving patient outcomes.
Purpose of the Study:
- To investigate the causes and clinical characteristics of COU in children.
- To assess renal status and growth patterns at diagnosis and during follow-up.
- To identify predictors for the development and progression of CKD in pediatric COU patients.
Main Methods:
- An observational, retrospective-prospective study was conducted over two years at a tertiary care hospital in South India.
- Sixty children diagnosed with COU were included, with a minimum follow-up of five years, including two years of prospective follow-up.
- Data on diagnosis, clinical presentation, renal function (creatinine, eGFR), blood pressure, and growth were collected and analyzed.
Main Results:
- The most common causes of COU were uretero-pelvic junction obstruction and posterior urethral valves, predominantly affecting males (88.3%).
- At diagnosis, 40% had elevated creatinine, 15% were hypertensive, and 25% experienced growth failure; these rates improved during follow-up.
- Hypertension at diagnosis (OR=12.8) and frequent urinary tract infections (UTI) (OR=14.06) were significant predictors of CKD progression.
Conclusions:
- Hypertension and recurrent UTIs are strongly linked to CKD progression in children with COU.
- Lower estimated glomerular filtration rate (eGFR) at diagnosis is associated with height faltering and hypertension during follow-up.
- Effective management preserving renal function is vital to prevent growth issues and hypertension, enhancing quality of life.
Objectives:
To study the etiology and clinical profile of congenital obstructive uropathy in children, renal status and growth at diagnosis and at follow-up and to determine the predictors for development of chronic kidney disease (CKD).
Methods:
An observational (retrospective-prospective) study was conducted at a tertiary care hospital in South India from September 2014 through September 2016. Sixty children diagnosed to have congenital obstructive uropathy with a minimum follow-up period of 5 y were included and followed up prospectively for 2 more years during the study period. The data of the children at admission and follow-up was obtained from the medical records and analyzed.
Results:
Congenital uretero-pelvic junction obstruction followed by Posterior urethral valve were the most common etiologies identified. Male preponderance (88.3%) was observed with poor urinary stream being the most common presentation (36.6%). Forty percent of the population had elevated creatinine. Fifteen percent were hypertensive and 25% had growth failure at diagnosis. However, there was a reduction in the number of children with poor estimated glomerular filtration rate (eGFR), hypertension and growth faltering during follow-up. Among the risk factors, hypertension at diagnosis [O.R-12.8 (2.21-74.22) and p value <0.05] and frequent urinary tract infection (UTI) [O.R-14.06 (2.32-85.42) and p value <0.05] were the most important factors for CKD progression. Children with low eGFR (< 60 ml/min/1.73m2) had more height faltering and hypertension at follow-up (p value <0.05).
Conclusions:
Hypertension and frequent UTI were observed to be strongly associated with progression of CKD. Estimated GFR was found to be significantly associated with faltering of height and hypertension. Preserving the renal function prevents growth faltering and development of hypertension at follow-up thereby ensuring a better quality of life.
Related Concept Videos
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...
02:24Ribosome Profiling
Applications of ribosome profiling
Ribosome profiling has many applications, including in vivo monitoring of translation inside a particular organ or tissue type and quantifying new protein synthesis levels.
The technique...
01:29Drug Dosing: Infants and Children
01:24Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...