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Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns

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Abstract

Background

Congenital abnormalities of the kidney and urinary tract (CAKUT) are significant causes of morbidity. The aim of the study was to determine predictive factors of mortality in newborns with CAKUT.

Methods

All 29,653 consecutive newborns hospitalized in a tertiary neonatal unit between 1996 and 2006 were evaluated. The main outcome was neonatal mortality. The variables analyzed as risk factors were maternal age, first pregnancy, low birth weight (LBW), prematurity, oligohydramnios, and CAKUT associated with other malformations (Associated CAKUT).

Results

CAKUT was detected in 524 newborns, with an overall prevalence of 17.7 per 1,000 live births. A total of 325 (62%) cases were classified as urinary tract dilatation, 79 (15.1%) as renal cystic disease, and 120 (22.9%) as other subgroups. In the urinary tract dilatation subgroup, independent risk factors for early mortality were Associated CAKUT [odds ratio (OR) 20.7], prematurity (OR 4.5) LBW (OR 3.8), oligohydramnios (OR 3.0), and renal involvement (OR 3.0). In the renal cystic disease subgroup, two variables remained associated with neonatal mortality: LBW (OR 12.3) and Associated CAKUT (OR 21.4).

Conclusion

The presence of extrarenal anomalies was a strong predictor of poor outcome in a larger series of infants with CAKUT.

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Acknowledgments

This study was partially supported by CNPq (Brazilian National Research Council, Grant 401949/2010-9), FAPEMIG (Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Grant PPM-00152-09), and the INCT-MM Grant (FAPEMIG: CBB-APQ-00075-09/CNPq 573646/2008-2). GMP and MCL were the recipients of CNPq fellowships. Dr. EA Oliveira and Dr. AC Simões e Silva received a research grant from the Brazilian Research Council (CNPq).

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Authors and Affiliations

  1. Division of Genetics, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Batielhe F. Melo, Marcos B. Aguiar & Regina L. Aguiar

  2. Neonatology Unit, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Maria Candida F. Bouzada

  3. Fetal Medicine Unit, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Alamanda K. Pereira

  4. Pediatric Nephrology Unit, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

    Gabriela M. Paixão, Mariana C. Linhares, Flavia C. Valerio, Ana Cristina Simões e Silva & Eduardo A. Oliveira

  5. Rua Engenheiro Amaro Lanari 389/501, Belo Horizonte, 30.310.580, MG, Brazil

    Eduardo A. Oliveira

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  1. Batielhe F. Melo
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  8. Flavia C. Valerio
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Correspondence to Eduardo A. Oliveira.

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Melo, B.F., Aguiar, M.B., Bouzada, M.C.F. et al. Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns. Pediatr Nephrol 27, 965–972 (2012). https://doi.org/10.1007/s00467-012-2107-y

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  • DOI: https://doi.org/10.1007/s00467-012-2107-y

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