Congenital Anomalies of Kidney and Urinary Tract in Children - Clinical Spectrum and Complications

To study the spectrum of congenital anomalies of the kidney and urinary tract (CAKUT), and to examine the clinical presentation and potential complications.

A total of 304 children were recruited (216 retrospectively and 88 prospectively). Clinical data were obtained from records in the retrospective cases, while clinical assessments, laboratory tests, and imaging were conducted as needed in the prospective cases.

Primary vesicoureteric reflux (VUR) was the most common cause of CAKUT (34.2%), followed by posterior urethral valve (PUV) at 24% and pelvi-ureteric junction obstruction (PUJO) at 13.1%. Antenatal detection was the most common mode of identification (47.6%), followed by detection after urinary tract infection (UTI) in 29.5% of cases. Extrarenal manifestations occurred in 6.5% of cases. Recurrent UTI was the most common complication, seen in 42.3%. Additionally, 11.5% had hypertension, and 10% had a glomerular filtration rate (GFR) of less than 60 ml/min/1.73 m².

Primary VUR is the most common CAKUT, and the antenatal detection of anomalies is crucial. The prevalence of chronic kidney disease (CKD) stage 2 and above is quite high among CAKUT, particularly PUV, renal hypodysplasia, and VUR, warranting close nephrology follow-up.