Konjenital Böbrek ve Üriner Sistem Anomalileri: Tek Merkez 14 Yıllık Deneyim

Yıl 2019, Cilt: 17 Sayı: 1, 45 - 57, 01.04.2019

Hüseyin Güngör Kenan Bek Mehtap Ezel Çelakıl Zelal Ekinci

Öz

GİRİŞ ve AMAÇ: Böbrek ve idrar yollarının konjenital anomalileri (DBÜSA)
genellikle asemptomatiktir ve çeşitli toplumlarda son dönem böbrek
yetmezliğinin% 30-60' ının sebebidir. ÇalışmamızdA DBÜSA'lı hastaların uzun
süreli epidemiyolojik, demografik ve klinik özelliklerini paylaşmayı amaçladık.

YÖNTEM ve GEREÇLER: Çalışmaya, Nisan 2002-Ocak 2016 tarihleri arasında Kocaeli
Üniversitesi Tıp Fakültesi Pediatrik Nefroloji Anabilim Dalı tarafından takip
edilen, 0-18 yaş arası 11725 hastadan toplam 4625 DBÜSA hastası dahil edildi.
Toplamda DBÜSA olan 4625 hasta teşhis edildi. Geçici hidronefroz tespit edilen
4164 hasta çalışmadan çıkarıldı. Çalışılan 461 hastanın kayıtları retrospektif
olarak değerlendirilmiş ve SPSS 20.0 programı ile analiz edilmiştir.

BULGULAR: DBÜSA sıklığı% 3,9 idi. Olguların erkek / kadın oranı % 48,8
(225) /% 51,2 (236) idi. VUR % 31,5 (145) hastada tespit edildi, bunların % 71,7
(104) kadın ve% 28,3 (41) erkekti. Hidronefroz, 75 (% 162) hastada mevcuttu. Bu
hastaların antenatal tanı oranı % 30,7 idi (23). UPJ obstrüksiyonu 26 (% 70,2)
ve VUR 21 (% 14,4) hidronefroz ile ilişkili en sık konjenital böbrek ve üriner
sistem anomalileri idi. Olguların % 50,5 (233) 'ünde idrar yolu enfeksiyonu
öyküsü vardı. VUR tanısı olan hastalarda bu sıklık % 90,3 olarak saptandı.
Kronik böbrek hastalığı 8 hastada mevcuttu. Bu hastaların 4'ünde (% 50) altta
yatan neden VUR idi.

TARTIŞMA ve SONUÇ: Son yıllarda, geçici hidronefroz prevalansı antenatal
USG'nin yaygın kullanımı ile artmıştır. Bu nedenle uzun dönemde kronik böbrek
hastalığı riski yüksek olan DBÜSA'lı hastalar geçici hidronefrozdan ayrılmalı
ve üçüncü basamak referans merkezlerinde pediatrik nefroloji ve pediatrik
üroloji ile takip edilmelidir.

Anahtar Kelimeler

Konjenital böbrek ve üriner sistem anomalisi, vezikoüreteral reflü, kronik böbrek hastalığı

Congenital Anomalies of Kidney and Urinary Tract (CAKUT): Single Center Experience for 14 Years

Öz

INTRODUCTION: Congenital anomalies of kidney and urinary tract (CAKUT) are
usually asymptomatic and the cause of 30-60 % of the end stage renal failure in
various societies. We aimed to share the long-term epidemiological, demographic
and clinical characteristics of the patients with CAKUT.

METHODS: A total of 4625 CAKUT patients, out of 11725 patients aged 0-18 years
who were followed up by Kocaeli University School of Medicine Pediatric
Nephrology Department between April 2002 and January 2016 were included in the
study. In total, 4625 patients with CAKUT were diagnosed and transient
hydronephrosis was detected in 4164 patients. These patients were excluded from
our study. The records of the patients studied were retrospectively evaluated
and analyzed by SPSS 20.0 program. 

RESULTS: CAKUT frequency was 3.9%. The male / female ratio of the cases
was 48.8% (225) / 51.2% (236). VUR was detected in 31.5% (145) patients,71.7%
(104) were female and 28.3% (41) male. Hydronephrosis was present in 75 (16.2%)
patients. The antenatal diagnosis rate of these patients was 30.7% (23). UPJ
obstruction 26 (70.2%) and VUR 21 (14.4%) were the most common congenital renal
and urinary system anomalies associated with hydronephrosis. 50.5% (233) of the
cases had a history of urinary tract infection. This frequency was
significantly higher in patients with VUR diagnosed as 90.3%. Chronic kidney
disease was present in 8 patients. The underlying cause in 4 (50%) of these
patients was VUR.

DISCUSSION AND CONCLUSION: In recent years, the prevalence of transient
hydronephrosis has been frequently reported with the widespread use of
antenatal USG. Therefore, patients with CAKUT who have a high risk of chronic
kidney disease in the long-term should be separated from transient hydronephrosis
and followed up at tertiary care reference centers with pediatric nephrology
and pediatric urology. 

Anahtar Kelimeler

Congenital kidney and urinary tract anomaly, vesicoureteral reflux, chronic kidney disease

Kaynakça

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