Renal outcome of congenital anomalies of the kidney and urinary tract system: a single-center retrospective study.

BACKGROUND: Congenital anomalies of the kidney and urinary tract (CAKUT) have been defined in 20% to 50% of all fetal anomalies. The aim of this study was to determine the demographic and clinical characteristics of such patients, as well as to describe the outcome and risk factors that affect the prognosis.

METHODS: The analysis investigated retrospective data from 303 patients diagnosed with CAKUT between January 2015 and April 2017. Demographic data, clinical history, diagnosis, investigations, disease outcomes, and treatment procedures were evaluated.

RESULTS: A total of 303 children were included (126 females, 177 males). The median age was 3.0 years (range 0.01-17), and the median follow-up time was 1.65 years (range 0.02-12). The most commonly diagnosed anomalies of CAKUT were hydronephrosis (N.=139; isolated HN, N.=58), followed by renal parenchymal malformations (N.=109), collecting system anomalies (N.=56), migration and fusion anomalies (N.=53), and abnormalities of the bladder and urethra (N.=27). In 56 cases with isolated hydronephrosis, ultrasound normalized at a median age of 0.9 years (range 0.02-6). Surgery was performed on 44 children, and anomalies persisted in 201 children without any need for intervention. Poor outcome was defined in patients with renal parenchymal malformations and patients with abnormalities of the bladder and urethra. For 28 children (9.3%) who developed chronic kidney disease, the most common diagnoses were vesicoureteral reflux and neurogenic bladder.

CONCLUSIONS: Children with isolated hydronephrosis had a good prognosis. The risk factors for poor outcome were postnatal bilateral anomalies, a need for surgery, and persisting anomalies with impaired renal function.