Pediatric Nephrology

, Volume 27, Issue 6, pp 949–953 | Cite as

Ultrasound mass screening for congenital anomalies of the kidney and urinary tract

  • Vito Antonio Caiulo
  • Silvana Caiulo
  • Clara Gargasole
  • Giovanni Chiriacò
  • Giuseppe Latini
  • Luigi Cataldi
  • Giuseppe Mele
Original Article

Abstract

Background

There is a high incidence of congenital anomalies of the kidneys and urinary tract (CAKUT). Early diagnosis of these defects may allow the best medical and/or surgical treatment to be implemented as rapidly as possible, preventing or at least slowing down an evolution toward chronic kidney disease.

Methods

Ultrasound mass screening for kidney and urinary tract abnormalities in infants at 2 months of age was carried out in Salento, Italy. The centers involved in the study examined a total of 17,783 infants between January 1992 and December 2010.

Results

A total of 171 CAKUT were identified in the course of the mass screening. The frequency of CAKUT was 0.96%. Vesicoureteral reflux (n = 39) was the most frequent renal abnormality found, followed by ureteropelvic junction obstruction (n = 33), ectopic kidney (n = 26), and renal dysplasia (n = 19). In addition, nephrogenic rests (n = 2), as well as several extra-renal pathologies, including abdominal neuroblastoma (n = 3), were diagnosed incidentally.

Conclusion

Ultrasound has been effective for early detection of renal and urinary tract anomalies. In addition, this screening has proved to be very useful for the early identification and management of both renal and extra-renal precancerous as well as cancerous lesions. However, most patients requiring surgery in this study (0.24%) would probably have been symptomatic and come to medical attention without routine screening. On the basis of our results screening is not justified.

Keywords

Ultrasound urinary mass screening Congenital anomalies of the kidneys 

References

  1. 1.
    Barakat AJ, Drougas JG (1991) Occurrence of congenital abnormalities of kidney and urinary tract in 13,775 autopsies. Urology 38:347–350PubMedCrossRefGoogle Scholar
  2. 2.
    Toka HR, Toka O, Hariri A, Nquien HT (2010) Congenital anomalies of kidney and urinary tract. Semin Nephrol 30:374–386PubMedCrossRefGoogle Scholar
  3. 3.
    Schedl A (2007) Renal abnormalities and their developmental origin. Nat Rev Genet 8:791–802PubMedCrossRefGoogle Scholar
  4. 4.
    Kerecuk L, Schreuder MF, Woolf AS (2008) Renal tract malformations: perspectives for nephrologists. Nat Clin Pract Nephrol 4:312–325PubMedCrossRefGoogle Scholar
  5. 5.
    US Renal Data System (USRDS) (2010) Annual Data Report: Atlas of Chronic Kidney Disease and End-Stage Renal Disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2010. Available at http://www.usrds.org/adr.htm Accessed 13 June 2011
  6. 6.
    North American Pediatric Renal Trials and Collaborative Studies, NAPRTCS 2011 annual report Available at https://web.emmes.com/study/ped/annlrept/annlrept.html Accessed 7 November 2011
  7. 7.
    Fivush BA, Jabs K, Neu AM, Sullivan EK, Feld L, Kohaut E, Fine R (1998) Chronic renal insufficiency in children and adolescents; the 1996 annual report of NAPRTCS. Pediatr Nephrol 12:328–337PubMedCrossRefGoogle Scholar
  8. 8.
    Hart JT (1998) Screening for urinary abnormalities. Lancet 351:1590PubMedCrossRefGoogle Scholar
  9. 9.
    American Academy of Pediatrics (1993) Recommendations for preventive pediatric health care. In: Policy reference guide: a comprehensive guide to AAP policy statement. American Academy of Pediatrics, Elk Grove VillageGoogle Scholar
  10. 10.
    Committee on Practice and Ambulatory Medicine (2000) American Academy of Pediatrics (2000) recommendations for preventive pediatric health care. Pediatrics 105:645–646CrossRefGoogle Scholar
  11. 11.
    Watson AR, Readett D, Nelson CS, Kapila L, Mayell MJ (1998) Dilemmas associated with antenatally detected urinary tract abnormalities. Arch Dis Child 63:719–722CrossRefGoogle Scholar
  12. 12.
    Steinhart JM, Kuhn JP, Eisenberg B, Vaughan RL, Maggioli AJ, Cozza TF (1988) Ultrasound screening of healthy infants for urinary tract abnormalities. Pediatrics 82:609–614PubMedGoogle Scholar
  13. 13.
    Yoshida J, Tsuchiya M, Tatsuma N, Marakami M (2003) Mass screening for early detection of congenital kidney and urinary tract abnormalities in infancy. Pediatr Int 45:142–149PubMedCrossRefGoogle Scholar
  14. 14.
    Riccipetitoni G, Chierici R, Tamisari L, De Castro R, Manfredi S, Veroni G, Susini P, Georgacopulo P, Vigi V (1992) Postnatal ultrasound screening of urinary malformations. J Urol 148:604–605PubMedGoogle Scholar
  15. 15.
    Scott JE, Lee RE, Hunter EW, Coulthard MG, Matthews JN (1991) Ultrasound screening of newborn urinary tract. Lancet 338:1571–1573PubMedCrossRefGoogle Scholar
  16. 16.
    Feier D, Fufezan O, Tătar S, Cobzac G, Popa RT (2010) Ultrasonography contribution in detection of reno-urinary anomalies: a cohort study. Med Ultrason 12:205–212PubMedGoogle Scholar
  17. 17.
    Caiulo VA, Latini G, Massafra V, Toscanelli A, Cataldi L, De Felice C (2005) Incidental detection of neuroblastoma and “Wait and See” strategy. Pediatr Blood Cancer 44:686PubMedCrossRefGoogle Scholar
  18. 18.
    Caiulo VA, Latini G, Cataldi L, De Felice C (2007) Nephrogenic rests: their frequency and their fate. J Pediatr Hematol Oncol 29:361–363PubMedCrossRefGoogle Scholar
  19. 19.
    Birth Defects Monitoring Program (BDMP) (1993) Commission on Professional and Hospital Activities (CPHA) surveillance data, 1988–1991. Teratology 48:658–675CrossRefGoogle Scholar
  20. 20.
    [no authors listed](1993) Metropolitan Atlanta congenital defects program surveillance data, 1988–1991. Teratology 48:695–709Google Scholar
  21. 21.
    Schulman J, Edmonds LD, McClearn AB, Jensvold N, Shaw GM (1993) Surveillance for and comparison of birth defect prevalences in two geographic areas–United States, 1983–88. MMWR CDC Surveill Summ 42:1–7PubMedGoogle Scholar
  22. 22.
    Sanna-Cherchi S, Ravani P, Corbani V, Parodi S, Haupt R, Piaggio G, Innocenti ML, Somenzi D, Trivelli A, Caridi G, Izzi C, Scolari F, Mattioli G, Allegri L, Ghiggeri GM (2009) Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int 76:528–533PubMedCrossRefGoogle Scholar
  23. 23.
    Sheih CP, Liu MB, Hung CS (1989) Renal abnormalities in school children. Pediatrics 84:1086–1090PubMedGoogle Scholar
  24. 24.
    Tsuchiya M, Hayashida M, Yanagihara T, Yoshida J, Takeda S, Tatsuma N, Tsugu H, Hino Y, Munakata E, Murakami M (2003) Ultrasound screening for renal and urinary tract anomalies in healthy infants. Pediatr Int 45:617–623PubMedCrossRefGoogle Scholar

Copyright information

© IPNA 2012

Authors and Affiliations

  • Vito Antonio Caiulo
    • 1
    • 2
  • Silvana Caiulo
    • 3
  • Clara Gargasole
    • 4
  • Giovanni Chiriacò
    • 5
  • Giuseppe Latini
    • 2
    • 6
  • Luigi Cataldi
    • 1
    • 7
  • Giuseppe Mele
    • 8
  1. 1.Neonatal Nephrology Study Group, Italian Society of NeonatologyBrindisiItaly
  2. 2.Division of NeonatologyPerrino HospitalBrindisiItaly
  3. 3.School of MedicineSan Raffaele UniversityMilanItaly
  4. 4.School of Medicine, San Paolo HumanitasUniversity of MilanMilanItaly
  5. 5.School of MedicineUniversity of TriesteTriesteItaly
  6. 6.Clinical Physiology Institute (IFC-CNR), National Research Council of ItalyLecceItaly
  7. 7.Department of Pediatric, School of MedicineCatholic University of RomaRomaItaly
  8. 8.Italian Federation of PediatriciansLecceItaly

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