All issues > Volume 52(4); 2009

Original Article

Korean J Pediatr. 2009;52(4):464-470. Published online April 15, 2009.

Incidence and outcome of congenital anomalies of the kidney and urinary tract detected by prenatal ultrasonography: a single center study

Gina Gn Lim¹, Joo Hoon JH Lee¹, Young Seo YS Park¹, Kun Seok KS Kim², Hye-Sung HS Won³

¹Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
²Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
³Department of Obstetric-Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Correspondence Young Seo YS Park ,Email: 1

Abstract

Purpose
: This study assessed the incidence and outcome of congenital anomalies of the kidney and urinary tract (CAKUT) detected by prenatal ultrasonography
Methods
: There were 906 cases of CAKUT detected by prenatal ultrasonography and postnatally confirmed at the Asan Medical Center from October 1989 to October 2007. We investigated the incidence and outcome of these cases by reviewing medical records retrospectively.
Results
: The order of incidence was hydronephrosis, multicystic dysplastic kidney (MCDK), duplex kidney, vesico-ureteral reflux (VUR), single kidney, hydroureteronephrosis, ectopic kidney, polycystic kidney, ureterocele, and posterior urethral valve (PUV). There were 520 cases (57.4%) of hydronephrosis, and 20% of these needed an operation due to significant obstruction. MCDK was associated with other CAKUT in 25.4% of all cases. Approximately 57.9% of duplex kidney cases needed surgical treatment due to ureterocele and VUR. VUR had a male: female ratio of 10:1. Two out of seven cases of autosomal recessive polycystic kidney had progressed to chronic renal failure. Patients with PUV were relatively uncommon, and one out of nine cases progressed to end-stage renal disease.
Conclusion
: CAKUTs detected by prenatal ultrasonography were composed of various anomalies, and almost all of them had a good outcome without any intervention. However, in some cases, recurrent urinary tract infection or renal failure occurred, especially in bilateral cases. For further management, a long-term multicenter study is needed to investigate the precise incidence and outcome of each anomaly in the general population.

Keywords :Congenital anomalies of the kidney and urinary tract, Prenatal ultrasonography, Incidence, Outcome