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The Indian Journal of Pediatrics

, Volume 86, Issue 4, pp 354–359 | Cite as

Clinical Profile and Outcome of Children with Congenital Obstructive Uropathy

  • Susmitha Tangirala
  • Nalini Bhaskaranand
  • Pushpa G. Kini
  • Kalyan Chakravarthy KondaEmail author
  • Sahithi Teja Gajjala
Original Article
  • 77 Downloads

Abstract

Objectives

To study the etiology and clinical profile of congenital obstructive uropathy in children, renal status and growth at diagnosis and at follow-up and to determine the predictors for development of chronic kidney disease (CKD).

Methods

An observational (retrospective-prospective) study was conducted at a tertiary care hospital in South India from September 2014 through September 2016. Sixty children diagnosed to have congenital obstructive uropathy with a minimum follow-up period of 5 y were included and followed up prospectively for 2 more years during the study period. The data of the children at admission and follow-up was obtained from the medical records and analyzed.

Results

Congenital uretero-pelvic junction obstruction followed by Posterior urethral valve were the most common etiologies identified. Male preponderance (88.3%) was observed with poor urinary stream being the most common presentation (36.6%). Forty percent of the population had elevated creatinine. Fifteen percent were hypertensive and 25% had growth failure at diagnosis. However, there was a reduction in the number of children with poor estimated glomerular filtration rate (eGFR), hypertension and growth faltering during follow-up. Among the risk factors, hypertension at diagnosis [O.R-12.8 (2.21–74.22) and p value <0.05] and frequent urinary tract infection (UTI) [O.R-14.06 (2.32–85.42) and p value <0.05] were the most important factors for CKD progression. Children with low eGFR (< 60 ml/min/1.73m2) had more height faltering and hypertension at follow-up (p value <0.05).

Conclusions

Hypertension and frequent UTI were observed to be strongly associated with progression of CKD. Estimated GFR was found to be significantly associated with faltering of height and hypertension. Preserving the renal function prevents growth faltering and development of hypertension at follow-up thereby ensuring a better quality of life.

Keywords

Congenital obstructive uropathy Chronic kidney disease  Hypertension 

Notes

Authors’ Contributions

ST,KCK,STG: Substantial contribution to conception and design, data collection, analysis and interpretation of the data and drafting the manuscript.

NB,PGK,KCK: Contributed for the design of the work, critical revision of the article and final approval of the version to be published. NB will act as guarantor for this article.

Compliance with Ethical Standards

Conflict of Interest

None.

Source of Funding

None.

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Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Department of PediatricsKasturba HospitalManipalIndia
  2. 2.Department of Pediatrics, Women and Child BlockKasturba HospitalManipalIndia

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