Clinical, Laboratory, Imaging Features and Prognosis in Pediatric Patients With Congenital Anomalies of the Kidney and the Urinary Tract (Cakut): A Referral Center Experience Publisher



M Mohkam MASOUMEH ; S Ghadimi SOODEH ; M Shafiei MOHAMMADREZA ; Ll Mohajerzadeh Leily LY ; M Khalili MITRA ; A Zahmatkesh AREFEH ; Ms Motaharifard Monireh SADAT ; R Alipour Aftabi RAZIYEH ; M Jafari MOHAMMADREZA ; F Kamali FARNAZ
Source: African Journal of Urology Published:2025

Abstract

Background: This study aims to evaluate the demographic, clinical, laboratory, and imaging findings in Iranian children diagnosed with congenital abnormalities of the kidney and urinary tract (CAKUT). Methods: All patients with a diagnosis of CAKUT referred to the Nephrology clinics of Mofid Children’s Hospital between 2018 and 2023 were included, and their medical records were retrospectively investigated and analyzed. Results: A total of 390 CAKUT patients [131 (33.6%) male and 259 (66.4%) female], at a median (IQR) age of 65.5 (44.8–115.3) months, were identified. The most frequent clinical manifestation was hydronephrosis (291, 74.6%), among whom 99 (25.4%) cases of vesicoureteral reflux (VUR), 94 (24.1%) cases of isolated hydronephrosis, 93 (23.8%) cases of posterior urethral valves (PUV), 67 (17.2%) cases of ureteropelvic junction obstruction (UPJO), 50 (12.8%) cases of neurogenic bladder, and 22 (5.6%) cases of ureterovesical junction obstruction (UVJO) were identified. 278 (71.3%) patients underwent surgery at a median (IQR) age of 24 (3–68.5) months. Patients were followed up for a median (IQR) duration of 42 (14.8–94) months, and 35 (9%) patients succumbed to their disease at a median (IQR) age of 34 (3.5–94.5) months. The most frequent causes of death were sepsis and infections (48% of all deaths) and ESRD (22% of all deaths). Conclusions: These findings suggest a delay in the diagnosis and management of CAKUT cases in Iranian patients. Early diagnosis of CAKUT in pediatric patients and parental/public education reduces long-term renal sequela and mortality rate. © 2025 Elsevier B.V., All rights reserved.