Radhakrishna Veerabhadra, Kumaravel Sambandan, Priyamvada P S, Hanumanthappa Nandeesha, Jindal Bibekanand, Govindarajan Krishnakumar, Naredi Bikash Kumar, Rijhwani Ashok
Department of Pediatric Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India.
Department of Nephrology, JIPMER, Pondicherry, India.
Kidney Dis (Basel). 2019 Feb;5(1):51-57. doi: 10.1159/000493683. Epub 2018 Oct 16.
Congenital anomalies of the kidney and urinary tract (CAKUT) are a group of disorders responsible for the majority of pediatric end-stage renal disease cases. There are only a few studies on CAKUT.
A study was conducted to determine the clinical and biochemical profile of children with CAKUT and to estimate the prevalence and the factors associated with hypertension in CAKUT.
A cross-sectional study was conducted in a tertiary center for 18 months from March 2014 to August 2015. Demographic data were recorded, and clinical examination including blood pressure measurement was performed. Various biochemical parameters including plasma renin activity (PRA), urinary beta-2-microglobulin (B2M), and microalbuminuria were evaluated.
A total of 81 patients with CAKUT were studied. Twenty-two (27%) patients were underweight, 4 (5%) patients were stunted, and 26 (32%) were both underweight and stunted. Children with bilateral disease had a higher incidence of underweight (21/44 vs. 8/37; = 0.04; 95% CI; Fisher exact test), and both underweight and stunted (25/44 vs. 10/37; = 0.006; 95% CI; Fisher exact test) compared to children with unilateral disease. Hypertension was found in 27% cases. No association was found between hypertension and PRA, BM2, or microalbuminuria in our study. PRA was inversely proportional to the estimated glomerular filtration rate (eGFR) (Pearson test; 95% CI; = 0.006).
Bilateral disease in CAKUT was significantly associated with poor somatic growth. PRA was inversely proportional to eGFR. The prevalence of hypertension was higher in children with CAKUT than in normal children and is possibly multifactorial as it was not associated with elevated PRA, B2M, or microalbuminuria.
先天性肾脏和尿路畸形（CAKUT）是导致大多数儿童终末期肾病病例的一组疾病。关于CAKUT的研究较少。
进行一项研究以确定CAKUT患儿的临床和生化特征，并估计CAKUT中高血压的患病率及相关因素。
2014年3月至2015年8月在一家三级中心进行了一项为期18个月的横断面研究。记录人口统计学数据，并进行包括血压测量在内的临床检查。评估了各种生化参数，包括血浆肾素活性（PRA）、尿β2-微球蛋白（B2M）和微量白蛋白尿。
共研究了81例CAKUT患者。22例（27%）患者体重不足，4例（5%）患者发育迟缓，26例（32%）患者体重不足且发育迟缓。与单侧疾病患儿相比，双侧疾病患儿体重不足的发生率更高（21/44对8/37；P = 0.04；95%CI；Fisher精确检验），体重不足且发育迟缓的发生率也更高（25/44对10/37；P = 0.006；95%CI；Fisher精确检验）。27%的病例发现有高血压。在我们的研究中，未发现高血压与PRA、BM2或微量白蛋白尿之间存在关联。PRA与估计的肾小球滤过率（eGFR）呈负相关（Pearson检验；95%CI；P = 0.006）。
CAKUT中的双侧疾病与身体生长发育不良显著相关。PRA与eGFR呈负相关。CAKUT患儿高血压的患病率高于正常儿童，并且可能是多因素的，因为它与PRA、B2M或微量白蛋白尿升高无关。
