儿童肾和尿路先天畸形的临床谱。

Clinical Spectrum of Congenital Anomalies of Kidney and Urinary Tract in Children.

机构信息

Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India. Correspondence to: Dr Sriram Krishnamurthy, Additional Professor, Department of Pediatrics, JIPMER, Puducherry-605006, India.

出版信息

Indian Pediatr. 2019 Jul 15;56(7):566-570.

PMID:31333211

Abstract

OBJECTIVES

To evaluate the clinical spectrum and patterns of clinical presentation in congenital anomalies of kidney and urinary tract.

METHODS

We enrolled 307 consecutively presenting children with congenital anomalies of kidney and urinary tract at the pediatric nephrology clinic. Patients were evaluated clinically, with serum biochemistry, appropriate imaging and radionuclide scans.

RESULTS

The most common anomaly was primary vesicoureteric reflux (VUR) (87, 27.3%), followed by pelviureteral junction obstruction (PUJO) (62,20.1%), multicystic dysplastic kidney (51 16.6%), non-obstructive hydronephrosis (32, 10.4%) and posterior urethral valves (PUV) (23, 7.4%). 247 (80.4%) anomalies had been identified during the antenatal period. Another 33 (10.7%) were diagnosed during evaluation of urinary tract infection, and 21 (6.8%) during evaluation for hypertension at presentation. Obstructive anomalies presented earlier than non-obstructive (7 (3, 22.5) vs 10 (4, 24) mo: (P=0.01)). The median (IQR) ages of presentation for children with PUV (n=23), VUR (n=87) and PUJO (n=62) were 4 (2, 14) mo, 10 (5, 27) mo, and 7 (3, 22.5) mo, respectively. Nine (2.9%) children had extrarenal manifestations.

CONCLUSIONS

The median age at clinical presentation for various subgroups of anomalies indicates delayed referral. We emphasize the need for prompt referral in order to initiate appropriate therapeutic strategies in children with congenital anomalies of kidney and urinary tract.

摘要

目的

评估先天性肾和尿路畸形的临床谱和临床表现模式。

方法

我们在儿科肾病诊所连续招募了 307 例先天性肾和尿路畸形患儿。对患者进行了临床评估，包括血清生化、适当的影像学和放射性核素扫描。

结果

最常见的异常是原发性输尿管反流（VUR）（87 例，27.3%），其次是肾盂输尿管交界处梗阻（PUJO）（62 例，20.1%）、多囊性发育不良肾（51 例，16.6%）、非梗阻性肾积水（32 例，10.4%）和后尿道瓣膜（PUV）（23 例，7.4%）。247 例（80.4%）异常在产前已被识别。另有 33 例（10.7%）在评估尿路感染时诊断，21 例（6.8%）在就诊时因高血压评估。梗阻性异常的表现早于非梗阻性异常（7 例[3，22.5%]比 10 例[4，24]月：P=0.01）。有 PUV（n=23）、VUR（n=87）和 PUJO（n=62）的患儿的中位（IQR）年龄分别为 4（2，14）月、10（5，27）月和 7（3，22.5）月。9 例（2.9%）患儿有肾外表现。