Background and aims: Congenital anomalies of the kidney and urinary tract (CAKUT) are a group of disorders responsible for the majority of pediatric end-stage renal disease cases. The CAKUT group is phenotypically variable and can affect the kidney alone and/or the lower urinary tract. The aim of the study was to assess the risk factors for the onset of chronic kidney disease (CKD) and the progression to kidney failure (KF, i.e., the need for dialysis or kidney transplantation) in a cohort of patients with CAKUT. Method: We conducted a longitudinal study at the Nephrology, Dialysis, and Transplantation Unit of Annunziata Hospital of Cosenza. We enrolled consecutive patients with CAKUT from 2005 to 2020. Risk factors for CKD and KF were assessed via Cox regression. Results: We studied 87 CAKUT patients (33 females and 54 males). Proteinuria and hypertension were present in 32.2% and 24.1%, respectively, and a high prevalence of urinary tract infections (UTI 56.3%). CAKUT distribution was: 24 bilateral parenchymal abnormalities (BA), 38 renal parenchymal unilateral diseases (PUD), and 25 tubular unilateral diseases (TUD). Proteinuria was more prevalent in BA than in PUD or TUD (54.2% vs 15.8% and 36%, p = 0.006), whereas regular growth was less frequent in BA (33.3% vs 81.6% and 88%, p < 0.001). During a median study follow-up of 205 months, 30 CKD events and 14 KF were registered. BA, anemia, proteinuria, and regular growth independently predicted CKD, while anemia and BA were associated with KF. Conclusion: The long follow-up in these children with CAKUT allowed us to find the predictive risk factors for CKD and progression of KF. Early and appropriate treatment of these risk factors could improve the prognosis of renal disease.
Predictors of chronic kidney diseases and kidney failure in patients with CAKUT: a cohort study
Provenzano M.;Di Dio M.;
2026-01-01
Abstract
Background and aims: Congenital anomalies of the kidney and urinary tract (CAKUT) are a group of disorders responsible for the majority of pediatric end-stage renal disease cases. The CAKUT group is phenotypically variable and can affect the kidney alone and/or the lower urinary tract. The aim of the study was to assess the risk factors for the onset of chronic kidney disease (CKD) and the progression to kidney failure (KF, i.e., the need for dialysis or kidney transplantation) in a cohort of patients with CAKUT. Method: We conducted a longitudinal study at the Nephrology, Dialysis, and Transplantation Unit of Annunziata Hospital of Cosenza. We enrolled consecutive patients with CAKUT from 2005 to 2020. Risk factors for CKD and KF were assessed via Cox regression. Results: We studied 87 CAKUT patients (33 females and 54 males). Proteinuria and hypertension were present in 32.2% and 24.1%, respectively, and a high prevalence of urinary tract infections (UTI 56.3%). CAKUT distribution was: 24 bilateral parenchymal abnormalities (BA), 38 renal parenchymal unilateral diseases (PUD), and 25 tubular unilateral diseases (TUD). Proteinuria was more prevalent in BA than in PUD or TUD (54.2% vs 15.8% and 36%, p = 0.006), whereas regular growth was less frequent in BA (33.3% vs 81.6% and 88%, p < 0.001). During a median study follow-up of 205 months, 30 CKD events and 14 KF were registered. BA, anemia, proteinuria, and regular growth independently predicted CKD, while anemia and BA were associated with KF. Conclusion: The long follow-up in these children with CAKUT allowed us to find the predictive risk factors for CKD and progression of KF. Early and appropriate treatment of these risk factors could improve the prognosis of renal disease.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
