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

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Abstract

Objective

To evaluate the clinical spectrum and patterns of clinical presentation in congenital anomalies of kidney and urinary tract.

Methods

We enrolled 307 consecutively presenting children with congenital anomalies of kidney and urinary tract at the pediatric nephrology clinic. Patients were evaluated clinically, with serum biochemistry, appropriate imaging and radionuclide scans.

Results

The most common anomaly was primary vesicoureteric reflux (VUR) (87, 27.3%), followed by pelviureteral junction obstruction (PUJO) (62,20.1%), multicystic dysplastic kidney (51 16.6%), non-obstructive hydronephrosis (32, 10.4%) and posterior urethral valves (PUV) (23, 7.4%). 247 (80.4%) anomalies had been identified during the antenatal period. Another 33 (10.7%) were diagnosed during evaluation of urinary tract infection, and 21 (6.8%) during evaluation for hypertension at presentation. Obstructive anomalies presented earlier than non-obstructive (7 (3, 22.5) vs 10 (4, 24) mo: (P=0.01)). The median (IQR) ages of presentation for children with PUV (n=23), VUR (n=87) and PUJO (n=62) were 4 (2, 14) mo, 10 (5, 27) mo, and 7 (3, 22.5) mo, respectively. Nine (2.9%) children had extrarenal manifestations.

Conclusions

The median age at clinical presentation for various subgroups of anomalies indicates delayed referral. We emphasize the need for prompt referral in order to initiate appropriate therapeutic strategies in children with congenital anomalies of kidney and urinary tract.

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Funding

Funding: None; Competing interests: None stated.

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Authors and Affiliations

  1. Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, 605006, India

    Bondada Hemanth Kumar, Sriram Krishnamurthy & Venkatesh Chandrasekaran

  2. Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India

    Bibekanand Jindal

  3. Department of Radiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India

    Ramesh Ananthakrishnan

Authors
  1. Bondada Hemanth Kumar
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  2. Sriram Krishnamurthy
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  3. Venkatesh Chandrasekaran
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  4. Bibekanand Jindal
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  5. Ramesh Ananthakrishnan
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Correspondence to Sriram Krishnamurthy.

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Kumar, B.H., Krishnamurthy, S., Chandrasekaran, V. et al. Clinical Spectrum of Congenital Anomalies of Kidney and Urinary Tract in Children. Indian Pediatr 56, 566–570 (2019). https://doi.org/10.1007/s13312-019-1556-9

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  • DOI: https://doi.org/10.1007/s13312-019-1556-9

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