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Long-term follow-up of congenital anomalies of the kidney and urinary tract diagnosed in utero: a longitudinal study

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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.

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Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Code availability

Not applicable.

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Funding

No funding was given for this study.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel

    Talia Israel, Yael Pasternak & Alina Weissmann-Brenner

  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

    Talia Israel, Weissbach Tal, Yael Pasternak & Alina Weissmann-Brenner

  3. Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Israel

    Weissbach Tal

Authors
  1. Talia Israel
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  2. Weissbach Tal
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  3. Yael Pasternak
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  4. Alina Weissmann-Brenner
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Drs. AW-B, TI, YP and TW. The first draft of the manuscript was written by Drs. TI and AW-B. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alina Weissmann-Brenner.

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Conflict of interest

All of the authors have made substantial contributions to the concept, data interpretation, drafting or critical revision of the manuscript for intellectual content and have approved the final version. There are no conflicts of interest for the authors.

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Approval was granted by the Meir Medical center Institutional Review Board no. 0115-18-MMC.

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Israel, T., Tal, W., Pasternak, Y. et al. Long-term follow-up of congenital anomalies of the kidney and urinary tract diagnosed in utero: a longitudinal study. J Nephrol 35, 567–573 (2022). https://doi.org/10.1007/s40620-021-01142-7

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  • DOI: https://doi.org/10.1007/s40620-021-01142-7

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