Alp Esma Keleş, Dönmez Muhammet İrfan, Alp Hayrullah, Elmacı Ahmet Midhat
Department of Pediatrics, Dr. Ali Kemal Belviranlı Women's Maternity and Children's Hospital, Konya, Turkey.
Department of Pediatrics, Karatay University, Konya, Turkey.
Congenit Anom (Kyoto). 2022 Jan;62(1):4-10. doi: 10.1111/cga.12443. Epub 2021 Aug 23.
Several congenital heart diseases (CHD) are present in children with congenital anomalies of the kidney and the urinary tract (CAKUT) in syndromic or nonsyndromic patterns. The purpose of this study was to identify nonsyndromic children with CAKUT who required echocardiographic evaluation and to find the prevalence of CHD in these patients. Retrospective chart review of nonsyndromic patients with CAKUT between 2012 and 2018 was conducted. Types of congenital anomalies of the kidney and urinary tract and echocardiogram reports of the patients, age, gender, prematurity, prenatal diagnosis of CAKUT, and family history were noted. Among 806 children with CAKUT, 135 patients underwent transthoracic echocardiographic evaluation and CHD was detected in 91 (11.2%). The most common type of CHD was secundum type atrial septal defect that was found in 73 (80.2%) patients. On the other hand, the most frequent types of congenital anomalies of the kidney and the urinary tract were isolated hydronephrosis and primary vesicoureteral reflux (61.4% and 12.8%, respectively). Our results showed that 75.8% of the patients with congenital heart diseases had isolated hydronephrosis. Finally, only 18 (2.2%) cases out of 806 patients that were evaluated via transthoracic echocardiography due to the clinical findings and family history had a CHD that required close (<6 months) follow-up. Congenital heart diseases that required close follow-up are rarely observed in nonsyndromic patients with CAKUT. Therefore, we suggest echocardiography should be performed in cases of clinical suspicion and family history rather than routinely in this patient group.
几种先天性心脏病(CHD)以综合征或非综合征模式存在于患有肾脏和尿路先天性异常(CAKUT)的儿童中。本研究的目的是识别需要超声心动图评估的非综合征性CAKUT患儿,并找出这些患者中CHD的患病率。对2012年至2018年间非综合征性CAKUT患者进行了回顾性病历审查。记录了肾脏和尿路先天性异常的类型、患者的超声心动图报告、年龄、性别、早产情况、CAKUT的产前诊断以及家族史。在806例CAKUT患儿中,135例接受了经胸超声心动图评估,其中91例(11.2%)检测出CHD。最常见的CHD类型是继发孔型房间隔缺损,在73例(80.2%)患者中发现。另一方面,肾脏和尿路最常见的先天性异常类型是孤立性肾积水和原发性膀胱输尿管反流(分别为61.4%和12.8%)。我们的结果显示,75.8%的先天性心脏病患者患有孤立性肾积水。最后,在806例因临床发现和家族史而接受经胸超声心动图评估的患者中,只有18例(2.2%)患有需要密切随访(<6个月)的CHD。在非综合征性CAKUT患者中很少观察到需要密切随访的先天性心脏病。因此,我们建议在临床怀疑和有家族史的情况下进行超声心动图检查,而不是在该患者群体中常规进行。