ESPN 51th Annual Meeting

ESPN 2018


 
Congenital malformative uropathies (CAKUT) and risk factors for ESRD in pediatric age
TERESA PAPALIA 1 ROSITA GRECO 1 DANILO LOFARO 2 RENZO BONOFIGLIO 1

1- NEPHROLOGY DIALYSIS AND TRANSPLANTANTION DEPARTMENT. ANNUNZIATA HOSPITAL. COSENZA. ITALY
2- **KIDNEY AND TRANSPLANTATION RESEARCH CENTER. ANNUNZIATA HOSPITAL . COSENZA. ITALY.
 
Introduction:

CAKUT include a wide range of structural malformations resulting from defects in the morphogenesis of the kidney and of the urinary tract. CAKUT are usually detected with prenatal sonography but many cases remain undiagnosed until adulthood.

The aim of this study was to identify the risk factors for ESRD already in pediatric age in children with malformative uropathies.

Material and methods:

Data were analyzed  for 52 children (20/32 F / M) with mean age 7.4 ± 3.9 years with diagnosis of CAKUT (renal dysplasia / hypoplasia / agenesis, vesico-ureteral reflux, urethral valves) afferent at our Pediatric Nephrology clinic in the period 2010-2015. For each, the creatinine at the entrance, the underlying pathology, the degree of acidosis, the PTHi, the hemoglobin and the positivity to the urinocolture detected during the first outpatient visit were evaluated. Survival analyzes were performed with Kaplan-Meier curves and Cox regressions to assess the risk of ESRD in pediatric age.

Results:

The study showed that children with renal hypoplasia (HR 4.83, 95% CI 1.01-23.1) and high creatinine at the entrance (1.39, 1.05-1.85) are at greater risk of ESRD already in pediatric age regardless of gender and from age, while children affected by abnormalities other than dysplasia present a slower evolution of chronic renal failure, reaching ESRD in adulthood.

Conclusions:

CAKUT are the most common form of birth defects and are the cause of ESRD in 40-50% of pediatric and 7% adulthood worldwide. The pediatric outcomes, as shown in this work, vary according to the CAKUT category.