pisco_log Publisher
Page Header

Ultrasound screening and follow-up study of congenital anom-alies of the kidney and urinary tract in neonates

Ningning Li, Lina Ji, Shuang Chao, Ke Yuan, Hong Meng, Zhengyu Huang, Huabin Zhang

Article ID: 2123
Vol 3, Issue 2, 2022

VIEWS - 50 (Abstract)

Abstract

Objective: To investigate the incidence of congenital anomalies of the kidney and urinary tract (CAKUT)in neonates, and to evaluate the value of urinary ultrasound screening in the early postnatal period. Methods: The neonates born or treated in Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University between January 2016 and December 2018 accepted the urinary ultrasound screening, and the neonates with problem were followed up. In the meanwhile, the maternal pregnancy data were analyzed to screen out the risk factors associated with the onset of CAKUT. Results: (1)A total of 2655 neonates were screened by ultrasonography, of whom 82 neonates had been diagnosed with CAKUT (male: 60 cases, female: 22 cases), the positive rate was 3. 1% (82 /2655). There were 66 cases of hydronephrosis, 6 cases of duplicate kidney, 2 cases of multiple renal cysts, 2 cases of renal cystic dysplasia, 1 case of medullary sponge kidney, 3 cases of small kidney, 1 case of isolated kidney, and 1 case of horseshoe kidney. (2)Of the 66 children with hydronephrosis, 4 cases were lost to the follow-up; 8 cases were followed for less than six months with no significant changes found, and still in the follow-up observation; 54 cases were followed up for 1 year, among which 32 cases were returned to normal within 1 year, 3 cases were alleviated, 7 cases were aggravated, and 12 cases were unchanged. One case underwent surgery for repeated urinary tract infections and decreased renal function. (3)Abnormal fetal urinary ultrasound in the late pregnancy was found to be the most common in the high risk factors of CAKUT. There were 44 high-risk newborns with abnormal fetal urinary ultrasound, and 35 cases of CAKUT were diagnosed after birth. The incidence rate was 795% (35 /44). (4)Among the 2655 newborns screened, 2611 newborns had normal antenatal urinary ultrasonography. Among these neonates with normal urinary ultrasound during pregnancy, 47 cases of CAKUT were diagnosed after birth, with an incidence of 18% (47 /2611). Conclusion: The most common CAKUT in neonates is hydronephrosis and most cases with hydronephrosis had a good prognosis, but they should be followed up regularly. Urinary ultrasound screening for neonates, especially those high-risk neonates with abnormal fetal urinary ultrasound, has important clinical implications for the early detection of CAKUT.


Keywords

anomalies; kidney and urinary tract; congenital; ultrasonography; neonates

Full Text:

XML



References

1. Pope JC, Brock JW, Adams MC, et al. How they begin and how they end: Classic and new the-ories for the development and deterioration of congenital anomalies of the kidney and urinary tract, CAKUT [J]. J Am Soc Nephrol, 1999, 10 (9 ): 20182028.

2. Caiulo VA, Caiulo S, Gargasole C, et al. Ultrasound mass screening for congital anomalies of the kidney and urinary tract [J]. Pediatr Nephrol, 2012, 27(6): 946953.

3. Smakal O, Janout V, Zapletalova J, et al. Diagnostic accuracy of postnatal ultrasound screening for uri-nary tract abnormalities[J]. Pediatr Nephrol, 2010, 25(2): 281287.

4. Toka HR, Toka O, Hariri A, et al. Congential anom-alies of kidney and urinary tract[J]. Semin Nephrol, 2010, 30 (4): 374386.

5. Yang Haiping, Luo Juan, Li Cuicui, et al Ultrasound screening analysis of urinary system in 14256 asymptomatic children [J] Journal of Chongqing Medical University, 2010, 36 (6): 926929

6. Zhang Bin, Wang Hui, Sun Ning, et al Clinical analysis of ultrasonic screening for congenital renal and urinary tract malformations in 26989 children [J] Chinese Journal of Pediatrics, 2011, 49 (7): 534538

7. Sun Qi, Kang Guogui, Sun Xiaoming, et al Clinical analysis of 56 neonates with congenital renal and urinary tract malformations [J] Modern Practical Medicine, 2016, 28 (8): 1062 - 1063

8. Shen Hanling, Zhu Youmin, Huang Gaoming, et al Ultrasound screening and follow-up management of neonatal congenital renal and urinary tract abnor-malities [J] Journal of Clinical Nephrology, 2013, 11 (11): 496499

9. Zhang Luan 2011–2012 Analysis of screening re-sults of urinary system abnormalities of high-risk infants in Minhang District [J] Chinese Journal of Child Health Care, 2014, 22 (7): 768770

10. Zong Dongmei, Sun Qi, Zhang Qi, et al Analysis of urological system ultrasonic screening and fol-low-up results of high-risk neonates in some areas of Ningbo [J] Zhejiang Clinical Medicine, 2018, 2 (2): 210212

11. Cheng Junli, Du Yue Chronic kidney disease in children [J] International Journal of Pediatrics, 2016, 43 (10): 788792

12. Soliman NA, Ali RI, Ghobrial EE, et al. Pattern of clinical presentation of congenital anomalies of the kidney and urinary tract among infants and chil-dren[J]. Nephrology, 2015, 20 (6 ): 627641.

13. Winyard P, Chitty LS. Dysplastic kidneys[J]. Semin Fetal Neonatal Med, 2008, 13(3): 142151.

14. Wang Xiaowen, Xu Hong Research strategies for congenital kidney and urinary tract malformations: From basic to clinical [J] Chinese Journal of Nephropathy of Integrated Traditional and Western Medicine, 2018, 19 (12): 11261128

15. Miyakita H, Ueno S, Nomura M. Neonatal hydro-nephrosis detected on routine health check-up[J]. Tokai J Exp Clin Med, 2001, 26(3): 101105.

16. Liu Liping, Li Sijin, Kang Chunsong, et al Ultra-sound evaluation and follow-up of neonatal hy-dronephrosis [J] Chinese Journal of Ultrasound Imaging, 2005, 14 (2): 131134

17. Wang Weiping, Mao Meng, Li Tingyu, et al Pediat-rics [M] Version 8 Beijing: People's Health Pub-lishing House, 2013: ninety-four

18. Hadlock FP, Deter RL, Carpenter R, et al. Sonogra-phy of fetal urinary tract anomalies[J]. Am J Roentgenol, 1981, 137 (2 ): 261267.

19. Zhang Xiaoying, Zhao Rui, Li Yinhua, etc Analysis of the application value of three-dimensional color Doppler ultrasound in the diagnosis of fetal geni-tourinary system malformations [J] Heilongjiang Medical Journal, 2014, 38 (4): 449450

20. Hálek J, Flgelová H, Michálková K, et al. Diag-nostic accuracy of postnatal ultrasound screening for urinary tract abnormalities[J]]. Pediatr Nephr, 2010, 25(2): 281287.

21. Broadley P, Mchugo J, Morgan I, et al. The 4 year outcome following the demonstation of bilateral renal pelvic dilatation on prenatal renal ultra-sound[J]. Br J Radiol, 1999, 72 (855 ): 265270.

22. Mouriquand PD, Whitten M, pracros JP. Patho-physiology diagnosis and management of prenatal upper tract dilatation[J]. Prenat Diagn, 2001, 21(11): 942951.

23. Woodward M, Frank D. Postnatal management of antenatal hydronephrosis[J]. BJU Int, 2002, 89(2): 149156.

24. Zhou Wanyi, Liu Lei Research status and progress in diagnosis and treatment of vesicoureteral reflux in children [J] Clinical Journal of Practical Hospital, 2017, 14 (4): 250253

25. Lu Mingna, Fan Qihui, Li Jie, etc The value and outcome follow-up of ultrasound diagnosis of fetal hydronephrosis [J] Modern Practical Medicine, 2018, 30 (11): 15191521

26. Bouzada MC, Oliveira EA, Pereira AK, et al. Diag-nostic accuracy of fetal renal pelvis anteroposterior diameter as a predictor of uropathy: A prospective study[J]. Ultrasound Obstet Cynecol, 2004, 24(7): 745749.

27. Tsuchiya M, Hayashida M, Yanagihara T, et al. Ul-trasound screening for renal and urinary tract anomalies in healthy infants[J]]. Pediatr Int, 2003, 45(5): 617623.

28. Zhang Huijing, Ma Jingmei, Yang Huixia, et al Research progress of fetal congenital renal and urethral malformations [J] Chinese Journal of Ob-stetrics and Gynecology, 2015, 50 (10): 791794

29. Ma Changjian, Wan Zhigang, Wang Yuanyuan, etc Research status of congenital renal and urinary tract malformations in children [J] International Journal of Pediatrics, 2018, 8 (8): 605608

30. Gong Yinu, Zhang Ying, Shen Qian, etc Study on screening and follow-up of renal pelvis dilatation in high-risk infants with three-level referral system for ultrasonic screening of congenital kidney and uri-nary tract malformations [J] Chinese Journal of Ev-idence Based Pediatrics, 2013, 8 (5): 326330


DOI: https://doi.org/10.54517/urr.v3i2.2123
(50 Abstract Views, 0 XML Downloads)

Refbacks

  • There are currently no refbacks.


Copyright (c) 2022 Ningning Li, Lina Ji, Shuang Chao, Ke Yuan, Hong Meng, Zhengyu Huang, Huabin Zhang

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License
This site is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.