Congenital Kidney and Urinary Tract Anomalies In Children(CAKUT); Single Center Experience

Yıl 2019, Cilt: 3 Sayı: 3, 93 - 100, 31.12.2019

Atilla Gemici , Bahriye Atmış , Raziye Ergün

Öz

Aim: Congenital anomalies of the kidney and urinary tract (CAKUT) in children include structural and functional malformations. These anomalies are the most common malformations in the prenatal period and constitute the leading cause of end-stage renal disease in children worldwide. In this study, the clinical, demographic, and treatment characteristics of the children with CAKUT were evaluated. 

Material and Methods: We retrospectively reviewed the medical records of the children with CAKUT who were admitted to our outpatient clinic during the two years period at Erzurum Regional Education and Research Hospital. Age, gender, family history, imaging studies and treatments were recorded. 

Results: The study included 378 patients. 179(47.4%)  children were female, 199(52.6%) children were males. The mean age was 38 months(min 1 month-max 212 months). In our study, ureteropelvic junction obstruction was detected in 132(35%) patients, primary vesicoureteral reflux was detected in 128(33.9%) patients, renal agenesis was detected in 34(9%) patients, and ectopic kidney was detected in 19(5.1%) patients, double collecting system was detected in 19(5.1%) patients, horseshoe kidney was detected in 16(4.2%) patients, renal hypoplasia was detected in 15(3.8%) patients, polycystic kidney disease was detected in 14(3.8%) patients, multicystic dysplastic kidney was detected in 13(3.4%) patients, uretero-vesical junction obstruction was detected in 11(2.9%) patients, ureterocele was detected in 10(2.7%) patients, posterior urethral valve was detected in 9(2.4%) patients and urethral hypoplasia was detected in one (0.3%) patient. Eighty-seven (22.9%) patients had renal scar and 13(3.4%) patients had chronic kidney disease. Forty-three patients had multiple CAKUT forms. Twenty-nine(7.7%) of the patients had a history of CAKUT in the family.. 

Conclusion: CAKUT may cause serious morbidity throughout life. Careful and regular monitoring of children from the antenatal period is important. Although early diagnosis reduces the risk of permanent renal damage in cases requiring treatment, it still plays an important role in CKD in our country. 

Çocuklarda Konjenital Böbrek ve Üriner Kanal Anomalisi(CAKUT); Tek Merkez Deneyimi

Öz

Amaç: Çocuklarda konjenital böbrek ve üriner kanal anomalisi (CAKUT), yapısal ve fonksiyonel malformasyonları içerir. Bu anomaliler doğum öncesi dönemde en sık görülen malformasyonlardır ve dünya çapında çocuklarda son dönem böbrek hastalığının önde gelen nedenini oluşturmaktadır. Bu çalışmada CAKUT tanısı ile takip edilen vakaların kli¬nik, demografik ve verilen tedavi özellikleri değerlendirildi. 

Gereç ve Yöntemler: Erzurum Bölge Eğitim ve Araştırma Hastanesine Mart 2017 ve Şubat 2019 arasındaki iki yıllık süre içinde kliniğimize başvuran ve CAKUT tanı¬sı alan vakaların dosyaları geriye dönük olarak incelendi. Dosya bilgilerinden yaş, cinsiyet, aile öyküsü, görüntüleme çalışmaları ve almış oldukları tedavileri kaydedildi. 

Bulgular: Çalışmamıza 378 olgu alındı, 179 kız(%47.4), 199 erkekti (%52.6), ortalama yaş 38 ay(en küçük 1 ay- en büyük 212 ay). Çalışmamızda olguların 132’sinde(%35) üreteropelvik darlık, 128’inde(%33.9) pri¬mer vezikoüreteral reflü, 34’ünde(%9) renal agenezi, 19’unda(%5.1) ektopik böbrek, 19’unda(%5.1) çift toplayıcı sistem, 16’sında(%4.2) at nalı böbrek, 15’inde(%3.8) renal hipoplazi, 14’ünde(%3.8) polikistik böbrek, 13’ünde(%3.4) multikistik displastik böbrek, 11’inde(%2.9) üreterovezikal darlık, üreterosel 10’unda(%2.7), 9’unda(%2.4) posterior üretral valv ve 1(%0.3) olguda üretra hipoplazisi tespit edildi.Olguların 87’inde(%22.9) böbrekte skar ve 13’ünde(%3.4) kronik böbrek hastalığı (KBH) mevcuttu. Olguların 43’ünde birden çok CAKUT formu mevcuttu. Ailede CAKUT öyküsü olan olgu 29(%7.7) olarak tespit edildi. 

Sonuç: CAKUT tüm hayat boyunca ciddi morbiditeye neden olabilir. Çocukların antenatal dönemden itibaren dikkatli ve düzenli takibi önemlidir. Tedavi gereken vakalarda erken dönemde teşhis, kalıcı renal hasar riskini azaltmakla birlikte halen ülkemizde KBH için önem rol oynamaktadır. 

Anahtar Kelimeler

Konjenital anomali, renal hasar, çocukluk çağı

Kaynakça

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