Early Hum Dev. 2025 Nov 13;213:106439. doi: 10.1016/j.earlhumdev.2025.106439. Online ahead of print.
ABSTRACT
BACKGROUND: Congenital malformations of the kidney and/or urinary tract (CAKUT) are nowadays widely detected prenatally and are the first cause of end-stage renal disease and kidney transplantation in children.
AIM: The aim of this study is to explore potential prenatal and postnatal factors associated with the need for postnatal surgery in children prenatally diagnosed with CAKUT.
METHODS: Patient data has been prospectively collected from a monocentric database. Were included children diagnosed with CAKUT at the time of routine prenatal ultrasound, between January 1, 2008 and December 31, 2015. Only children with at least 12 months postnatal follow-up were analyzed. Prenatal and postnatal imaging, laboratory results and operative reports were retrospectively reviewed. Based on their CAKUT diagnosis at birth, patients were divided in three groups: high, intermediate, low likelihood of requiring surgical management. Patients from the intermediate sub-group were further analyzed to determine potential clinical or radiological factors associated with need for surgery.
RESULTS: 147 patients were included. In total, 39 patients with CAKUT required surgery (26 %). Mean time to surgery was 6 months (0-62 months). 105/147 (71 %) patients had intermediate likelihood of requiring surgical management for their postnatal CAKUT diagnosis. In this subgroup, 30/105 patients (28 %) were operated on. A visible ureter on prenatal ultrasound and an anterior posterior renal pelvis diameter ≥ 10 mm, were associated with postnatal surgical management in our practice.
CONCLUSION: Prenatal and postnatal ultrasound are important non-invasive tools to detect children with a prenatal CAKUT diagnosis that may require surgery.
PMID:41264970 | DOI:10.1016/j.earlhumdev.2025.106439
