ESPE Abstracts

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) represent several types of malformations with occurrence of 1 in about 500 live births.

Objective and hypotheses: Small for gestation age (SGA) may influence prevalence of CAKUT and progression of chronic kidney disease (CKD) in children. The aim of this study was to elaborate prevalence, clinical features and outcome of SGA born children with associated CAKUT.

Method: Our cohort consisted of 100 SGA born children investigated for associated congenital anomalies of urinary tract. We analysed anthropometric and clinical birth data in these children with diagnosed CAKUT and estimated a stage and time of onset of chronic kidney disease by biochemical and imaging technics.

Results: We revealed that 7 (7.0%) SGA born children had associated CAKUT. Their mean birth weight was very low (1855 gr/−3.93 SDS) and birth length (45.57 cm/−2.17 SDS), as well. A significant growth failure with reduced weight and BMI were noticed at the time of diagnosis. A diagnosis of CAKUT in 4/7 of them was established in the first few months of life, but in others 3 later in early childhood. Two of three children diagnosed with unilateral kidney agenesis had normal glomerular filtration rate (GFR). Two children with hypo-dysplastic kidneys and 1 child with vesicoureteral reflux grade 2 had Stage 2 CKD (GFR 60–90 ml/min/1.73m²). Another patient with vesicoureteral reflux grade 3 was staged 3 CKD at GFR 47.2 ml/min/1.73 m². One child with stage 5 CKD needed kidney transplantation.

Conclusion: Herein we presented 7 SGA born children with CAKUT from Macedonia. Early recognition, assessment and treatment of these anomalies might improve the quality of life of these children.