A Hospital Based Cross-Sectional Study to Evaluate the Spectrum of Congenital Anomalies of Kidney and Urinary Tract, and Clinico-Epidemiological Characteristics

Background and Aim: To determine the spectrum of congenital anomalies of kidney and urinary tract (CAKUT) in Indian children, and to evaluate its clinico-epidemiological characteristics. Methods: A tertiary-care, hospital-based cross-sectional study conducted (November 2016-October 2018) at SCBMCH & SVPPGIP Hospital included children aged ≤14 years with a diagnosis of CAKUT. Incidence of individual congenital anomalies and clinico-epidemiological characteristics of each anomaly thus considered were evaluated. Results: In 140 children, 9 types of congenital anomalies were reported; posterior urethral valve was most common (37.85%) followed by pelvi-ureteric junction obstruction (32.14%) and vesico-ureteric reflux (14.28%). Hypospadiasis (5%), renal agenesis (2.86%), multicystic kidney disease (2.86%), duplication of pelvi-calyceal system (2.14%), horseshoe kidney (1.42%) and ureterocele (1.42%) were other CAKUTs. A total of 68.57% were boys (girls=31.43%). The CAKUTs were observed more in children with: age 1-5 years (32.14%), unilateral disease (45%), and term delivery (67.86%), and in children of mother aged >30 years (58.57%). Diabetes was present in mothers of 4 children (gestational: 2, pre-gestational: 2), hypertension in 3, tobacco use in 5, oligohydramnios in 7 and polyhydramnios in 3 mothers. Majority of the children had asymptomatic (37.86%) manifestation followed by burning micturition (31.43%). Non-renal congenital anomalies were present in 15.71% children (gastrointestinal malformations: 5.71% were most common). Positive family history for CAKUT was seen in 7.8% cases. Conclusion: The most frequent CAKUTs were posterior urethral valve and pelvi-ureteric junction obstruction in our study. The study also provided the clinico-epidemiological characteristics of CAKUT. These data can be helpful for prenatal counseling and management of CAKUTs.