1. Long-term follow-up of congenital anomalies of the kidney and urinary tract diagnosed in utero: a longitudinal study.
- Author
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Israel T, Tal W, Pasternak Y, and Weissmann-Brenner A
- Subjects
- Child, Female, Follow-Up Studies, Humans, Kidney abnormalities, Kidney diagnostic imaging, Longitudinal Studies, Pregnancy, Retrospective Studies, Urinary Tract diagnostic imaging
- Abstract
Background: Congenital-anomalies of the kidney-and-urinary-tract (CAKUT) are diagnosed in 3-6 per 1000 live-births. The objective of the current study was to examine the short and long-term outcomes of children diagnosed prenatally with CAKUT., Methods: A retrospective study was performed in 2018 on all pregnancies diagnosed with CAKUT between 2004 and 2008 at our hospital. Pregnancy outcomes and long-term morbidity were evaluated. Comparison was made between mild and severe forms of CAKUT and between unilateral and bilateral anomalies., Results: Ninety-eight children were included in the study. Most of them were born with an adequate weight for gestational-age, and were born at term by vaginal-deliveries. Children with major renal anomalies suffered significantly more frequently from recurrent UTIs (33.3% vs. 8.4%), needed more preventive antibiotics (50% vs. 20.5%), and had more renal surgeries (75% vs. 28%) than those with milder forms of CAKUT. Significantly more children with polycystic/multicystic kidney disease had recurrent UTIs (50% compared to 25% of the children with renal agenesis, and 5.6% of the children with hydronephrosis/hydroureter). There were no significant differences in the need for neurodevelopmental follow-up between the different groups of severity. Unilateral CAKUT patients required longer periods of nephrologist follow-up and repeated sonographic exams compared to bilateral CAKUT patients. Children with bilateral CAKUT more often needed special educational support than peers with unilateral disease (29.4% vs. 11.1%, P = 0.03)., Conclusions: Pregnancies whose children are diagnosed with CAKUT in utero usually deliver at term, with adequate-weight for gestational-age. The most common long-term comorbidities in children were recurrent UTIs and the use of preventive antibiotics was often needed. Expecting couples can be reassured of a generally good outcome of their children, at least during the first decade of life., (© 2021. Italian Society of Nephrology.)
- Published
- 2022
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