ESPN 50th Annual Meeting

ESPN 2017


 
Congenital abnormalities of kidney and urinary tract: antenatal and postnatal diagnosis
AGNIESZKA SZAFRANSKA 1 BARBARA KROLAK-OLEJNIK 1 KATARZYNA KILIS-PSTRUSINSKA 2

1- DEPARTMENT OF NEONATOLOGY, WROCLAW MEDICAL UNIVERSITY, WROCLAW, POLAND
2- DEPARTMENT OF PEDIATRIC NEPHROLOGY, WROCLAW MEDICAL UNIVERSITY, WROCLAW, POLAND
 
Introduction:

Congenital abnormalities of kidney and urinary tract (CAKUT) are an important cause of childhood morbidity. CAKUT can lead to end-stage renal disease in children and also cause subsequent renal problems in adulthood. Many of congenital abnormalities are detected in the antenatal or immediate postnatal.

The aim of the study was to analyze the occurrence of CAKUT and the usefulness of abdominal ultrasound (USG) screening in the population of 1752 newborns hospitalized in one neonatal center in the years 2014-2015.

 

Material and methods:

The clinical databases concerning newborns and their USG results were analyzed. In 2014 USG was performed only in newborns with medical indications. In 2015 USG was performed also as screening in healthy term newborns.

Results:

Year

2014

2015

Total number of tested newborns

537

1215

Newborns born > 37 1/7 weeks of pregnancy

333 (62%)

955 (79%)

Newborns born prematurely 33 0/7 -37 0/7

146 (27%)

186 (15%)

Newborns born prematurely 22 0/7 - 32 6/7

58 (11%)

74 (6%)


There were 187 abnormalities in the low-risk population with normal prenatal screening. In most cases CAKUT were benign in the form of small to medium-degree enlargement of the kidney pelvis. In addition developing ovarian cysts and spleen cysts were diagnosed. However, neuroblastoma in two cases and renal agenesis in two cases were detected. In 71 children prenatal abnormalities were confirmed. In 31 (44%) of those newborns USG showed severe urinary system abnormalities.
In total, CAKUT were observed in 15% of tested newborns. They required intensive treatment or implementation of further diagnostics and follow-up. Such a high percentage of CAKUT may result from screening of newborns whose mothers were hospitalized at the highest referral center.

Conclusions:

Postnatal abdominal ultrasound in newborns as a complement to antenatal screening ultrasonography allows detecting additional pathologies that may not produce clinical symptoms in early life.