Clinical characteristics of children with congenital anomalies of kidney and urinary tract and predictive factors for Chronic Kidney Disease in a tertiary hospital, Addis Ababa, Ethiopia

Abstract

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading causes of chronic kidney disease (CKD) in  childhood. Determining the clinical course, outcome, and prognostic factors of this heterogeneous group of diseases is important to  provide appropriate management and follow-up. Therefore, we aimed to identify the risk factors of CKD in CAKUT and the differences in  clinical courses between subtypes of CAKUT.

Methods: a retrospective cross-sectional study was done in 134 patient records diagnosed  with congenital kidney and urinary tract anomalies. They were categorized with subtypes of CAKUT and a chi-square test and logistic  regression analysis were done to determine risk factors for CKD and the result is presented in tables.

Results: Among the 134 patients,  males were 107 (79.9%) and the commonest subtypes of CAKUT were posterior urethral valve in 42 (31.3%), ureteropelvic junction  obstruction in 28 (20.9%), multicystic dysplastic kidney in 24 (17.9%). The median age of the study population at the time of diagnosis was  2.5 yrs. Among available 50 prenatal ultrasounds, the most frequent diagnoses were hydronephrosis in 38 patients (28.4%) and MCDK in 9  patients (6.7%). A total of 21(15.7%) patients had CKD and 6 of them (4.5%) progressed to end-stage kidney disease (ESRD). The  multivariate logistic regression analysis identified proteinuria on follow-up as an independent risk factor for CKD. (p=0.004)

Conclusion:  Posterior urethral valve is the commonest congenital anomaly of the kidney and urinary tract and proteinuria is an independent risk  factor for CKD.