Wisnu Gusti Ngurah P Pradnya, Situmorang Gerhard Reinaldi, Wahyudi Irfan, Rodjani Arry, Fahlevi Reza, Raharja Putu Angga Risky
Department of Urology, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Nephrology Division of Child Health Department, Faculty of Medicine, University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Early Hum Dev. 2025 Jun;205:106252. doi: 10.1016/j.earlhumdev.2025.106252. Epub 2025 Apr 1.
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.
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.
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.
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.
先天性肾脏和尿路畸形（CAKUT）是最常见的先天性畸形之一，在超过1%的活产婴儿中出现，占儿童慢性肾衰竭病例的40-50%。CAKUT的患病率是多方面的，差异很大。本研究旨在报告与CAKUT发病率相关的发病率、趋势和危险因素的最新证据。
我们对PubMed、ScienceDirect、Scopus和Proquest数据库进行了系统检索。然后使用纽卡斯尔-渥太华（NOS）偏倚风险工具对纳入的研究进行评估。使用Review Manager 5.4.1版软件进行荟萃分析，并以合并发病率和比值比（OR）以及95%置信区间呈现。
2004年至2022年共纳入八项研究（12838例各年龄段患有CAKUT的婴儿）。NOS偏倚风险工具表明所有研究的偏倚风险较低。所有婴儿中CAKUT的总体合并发病率为每1000例出生13.6例（95%置信区间：每1000例出生4至45.7例），足月无先天性畸形婴儿中为每1000例出生4.9例（95%置信区间：每1000例出生1.1至21.3例），且多年来呈上升趋势。还发现性别（男孩）（OR = 1.53；95%置信区间1.26-1.86）、早产（OR = 1.46；95%置信区间1.27-1.67）、低出生体重（OR = 1.28；95%置信区间1.10-1.48）、母亲糖尿病（OR = 1.81；95%置信区间1.43-2.28）、母亲肥胖（OR = 1.45；95%置信区间1.23-1.70）和母亲年龄（>40岁）等因素是CAKUT发病的危险因素。此外，一项研究报告种族（黑人[OR = 0.89；95%置信区间0.87-0.91]和西班牙裔[OR = 1.22；95%置信区间1.18-1.25]）是CAKUT的危险因素。
CAKUT的发病率较高，且多年来呈上升趋势。还发现性别、早产、低出生体重、母亲糖尿病、母亲肥胖、母亲年龄和种族等几个危险因素与CAKUT发病率相关。这些发现应提高对高危人群中CAKUT发病率的认识。
