Abstract

OKORONKWO, N C; LEVY, C; KHUMALO, T  and  MOONSAMY, G. Congenital anomalies of the kidney and the urinary tract in a South African paediatric nephrology setting. S. Afr. j. child health [online]. 2020, vol.14, n.1, pp.40-44. ISSN 1999-7671.  http://dx.doi.org/10.7196/SAJCH.2020.v14.i1.01666.

BACKGROUND. Congenital anomalies of the kidney and the urinary tract (CAKUT) are responsible for 34 - 59% of chronic kidney disease (CKD) and for 30 - 50% of cases of end-stage renal disease (ESRD) in children. OBJECTIVE. The aim of this study was to document the frequency and types of CAKUT in our centre. METHODS. Patients aged between 2 weeks and 18 years with CAKUT, who attended the paediatric nephrology division of the Charlotte Maxeke Johannesburg Academic Hospital over a 10-year period, were retrospectively reviewed. The different types of CAKUT were classified into anomalies of the kidney, anomalies of the collecting system, anomalies of the bladder, and anomalies of the urethra. Results. Over the study period (January 2005 - December 2014), 138 patients presented with CAKUT, giving a proportion for CAKUT of 20% of the total number of patients seen. However, 4 records were excluded from analysis because the patients were lost to follow-up. There were 109 male and 25 female patients, giving a male:female ratio of 4.4:1. The median age (interquartile range (IQR)) at presentation was 8.4 (IQR 1.9 - 47.7) months. The most common type of CAKUT was anomalies of the urethra (n=60; 45%), while the least was anomalies of the bladder (n=10; 7%). The percentage of primary vesicoureteral reflux (VUR) in our study was 4.5%. Posterior urethral valve was the only form of urethral anomaly documented in the study. CONCLUSION. The percentage of CAKUT in our setting is significant. Anomalies of the urethra were the most common CAKUT while anomalies of the bladder were the least. The frequency of VUR in South African children is much lower than that described in developed countries. Children with CAKUT should be on regular medical follow-up to prevent both early and late complications.

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