Division of Genetics, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
Pediatr Nephrol. 2012 Jun;27(6):965-72. doi: 10.1007/s00467-012-2107-y. Epub 2012 Mar 9.
Congenital abnormalities of the kidney and urinary tract (CAKUT) are significant causes of morbidity. The aim of the study was to determine predictive factors of mortality in newborns with CAKUT.
All 29,653 consecutive newborns hospitalized in a tertiary neonatal unit between 1996 and 2006 were evaluated. The main outcome was neonatal mortality. The variables analyzed as risk factors were maternal age, first pregnancy, low birth weight (LBW), prematurity, oligohydramnios, and CAKUT associated with other malformations (Associated CAKUT).
CAKUT was detected in 524 newborns, with an overall prevalence of 17.7 per 1,000 live births. A total of 325 (62%) cases were classified as urinary tract dilatation, 79 (15.1%) as renal cystic disease, and 120 (22.9%) as other subgroups. In the urinary tract dilatation subgroup, independent risk factors for early mortality were Associated CAKUT [odds ratio (OR) 20.7], prematurity (OR 4.5) LBW (OR 3.8), oligohydramnios (OR 3.0), and renal involvement (OR 3.0). In the renal cystic disease subgroup, two variables remained associated with neonatal mortality: LBW (OR 12.3) and Associated CAKUT (OR 21.4).
The presence of extrarenal anomalies was a strong predictor of poor outcome in a larger series of infants with CAKUT.
先天性肾和尿路畸形（CAKUT）是发病率的重要原因。本研究旨在确定 CAKUT 新生儿死亡的预测因素。
评估了 1996 年至 2006 年间在一家三级新生儿病房住院的 29653 例连续新生儿。主要结局是新生儿死亡率。分析的变量为母亲年龄、首次妊娠、低出生体重（LBW）、早产、羊水过少和与其他畸形相关的 CAKUT（相关 CAKUT）。
在 524 例新生儿中发现了 CAKUT，总体患病率为每 1000 例活产 17.7 例。共有 325 例（62%）病例被归类为尿路扩张，79 例（15.1%）为肾囊性疾病，120 例（22.9%）为其他亚组。在尿路扩张亚组中，与早期死亡相关的独立危险因素是相关 CAKUT（比值比[OR] 20.7）、早产（OR 4.5）、LBW（OR 3.8）、羊水过少（OR 3.0）和肾脏受累（OR 3.0）。在肾囊性疾病亚组中，两个变量仍然与新生儿死亡率相关：LBW（OR 12.3）和相关 CAKUT（OR 21.4）。
在较大系列的 CAKUT 婴儿中，存在肾外异常是不良结局的强烈预测因素。
