Factors affecting the incidence of congenital anomaly of the kidney and urinary tract: A systematic review and meta-analysis.

INTRODUCTION

Congenital anomaly of kidney and urinary tract (CAKUT) is one of the most common congenital anomalies, occurring in over 1 % of live births and accounting for 40-50 % of chronic kidney failure cases in children. The prevalence of CAKUT was multifaceted and varies widely. This study aimed to report the latest evidence of incidence, trends, and risk factors associated with the incidence of CAKUT.

EVIDENCE ACQUISITION

We conducted a systematic search of PubMed, ScienceDirect, Scopus, and Proquest databases. The included studies were then assessed using Newcastle-Ottawa (NOS) risk of bias tools. Meta-analysis was performed using Review Manager version 5.4.1 software and presented as pooled incidence and Odds Ratio (OR) with a 95 % confidence interval.

EVIDENCE SYNTHESIS

Eight studies in total were included from 2004 to 2022 (12.838 infants with CAKUT of all ages). NOS risk of bias tools indicated all studies had low risk of bias. The overall pooled incidence of CAKUT was 13,6 per 1000 births (95 % CI: 4 to 45,7 per 1000 births) in all infants and 4,9 per 1000 births (95 % CI: 1,1 to 21,3 per 1000 births) in term infants without congenital anomalies, with an increasing trend over the years. Factors, such as sex (boys) (OR = 1,53; 95 % CI 1,26-1,86), prematurity (OR = 1,46; 95 % CI 1,27-1,67), low birth weight (OR = 1,28; 95 % CI 1,10-1,48), maternal diabetes (OR = 1,81; 95 % CI 1,43-2,28), maternal obesity (OR = 1,45; 95 % CI 1,23-1,70), and maternal age (>40 years) were also found to be risk factors of CAKUT incidence. Furthermore, one study reported race (black people [OR = 0,89; 95 % CI 0,87-0,91] and Hispanics [OR = 1,22; 95 % CI 1,18-1,25]) to be a risk factor of CAKUT.

CONCLUSIONS

The incidence of CAKUT was high and showed an increasing trend over the years. Several risk factors, such as sex, prematurity, low birth weight, maternal diabetes, maternal obesity, maternal age and race were also found to be associated with CAKUT incidence. These findings should increase awareness regarding CAKUT incidence in at-risk populations.