Clinical Profile and Outcome of Children with Congenital Obstructive Uropathy

Susmitha Tangirala, Nalini Bhaskaranand, Pushpa G. Kini, Kalyan Chakravarthy Konda, Sahithi Teja Gajjala

Research output: Contribution to journalArticle

Abstract

Objectives: To study the etiology and clinical profile of congenital obstructive uropathy in children, renal status and growth at diagnosis and at follow-up and to determine the predictors for development of chronic kidney disease (CKD). Methods: An observational (retrospective-prospective) study was conducted at a tertiary care hospital in South India from September 2014 through September 2016. Sixty children diagnosed to have congenital obstructive uropathy with a minimum follow-up period of 5 y were included and followed up prospectively for 2 more years during the study period. The data of the children at admission and follow-up was obtained from the medical records and analyzed. Results: Congenital uretero-pelvic junction obstruction followed by Posterior urethral valve were the most common etiologies identified. Male preponderance (88.3%) was observed with poor urinary stream being the most common presentation (36.6%). Forty percent of the population had elevated creatinine. Fifteen percent were hypertensive and 25% had growth failure at diagnosis. However, there was a reduction in the number of children with poor estimated glomerular filtration rate (eGFR), hypertension and growth faltering during follow-up. Among the risk factors, hypertension at diagnosis [O.R-12.8 (2.21–74.22) and p value <0.05] and frequent urinary tract infection (UTI) [O.R-14.06 (2.32–85.42) and p value <0.05] were the most important factors for CKD progression. Children with low eGFR (< 60 ml/min/1.73m 2 ) had more height faltering and hypertension at follow-up (p value <0.05). Conclusions: Hypertension and frequent UTI were observed to be strongly associated with progression of CKD. Estimated GFR was found to be significantly associated with faltering of height and hypertension. Preserving the renal function prevents growth faltering and development of hypertension at follow-up thereby ensuring a better quality of life.

Original languageEnglish
Pages (from-to)354-359
Number of pages6
JournalIndian Journal of Pediatrics
Volume86
Issue number4
DOIs
Publication statusPublished - 10-04-2019

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Hypertension
Chronic Renal Insufficiency
Glomerular Filtration Rate
Urinary Tract Infections
Growth
Kidney
Tertiary Healthcare
Growth and Development
Tertiary Care Centers
Medical Records
Disease Progression
India
Creatinine
Retrospective Studies
Quality of Life
Prospective Studies
Population

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Tangirala, Susmitha ; Bhaskaranand, Nalini ; Kini, Pushpa G. ; Konda, Kalyan Chakravarthy ; Gajjala, Sahithi Teja. / Clinical Profile and Outcome of Children with Congenital Obstructive Uropathy. In: Indian Journal of Pediatrics. 2019 ; Vol. 86, No. 4. pp. 354-359.
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abstract = "Objectives: To study the etiology and clinical profile of congenital obstructive uropathy in children, renal status and growth at diagnosis and at follow-up and to determine the predictors for development of chronic kidney disease (CKD). Methods: An observational (retrospective-prospective) study was conducted at a tertiary care hospital in South India from September 2014 through September 2016. Sixty children diagnosed to have congenital obstructive uropathy with a minimum follow-up period of 5 y were included and followed up prospectively for 2 more years during the study period. The data of the children at admission and follow-up was obtained from the medical records and analyzed. Results: Congenital uretero-pelvic junction obstruction followed by Posterior urethral valve were the most common etiologies identified. Male preponderance (88.3{\%}) was observed with poor urinary stream being the most common presentation (36.6{\%}). Forty percent of the population had elevated creatinine. Fifteen percent were hypertensive and 25{\%} had growth failure at diagnosis. However, there was a reduction in the number of children with poor estimated glomerular filtration rate (eGFR), hypertension and growth faltering during follow-up. Among the risk factors, hypertension at diagnosis [O.R-12.8 (2.21–74.22) and p value <0.05] and frequent urinary tract infection (UTI) [O.R-14.06 (2.32–85.42) and p value <0.05] were the most important factors for CKD progression. Children with low eGFR (< 60 ml/min/1.73m 2 ) had more height faltering and hypertension at follow-up (p value <0.05). Conclusions: Hypertension and frequent UTI were observed to be strongly associated with progression of CKD. Estimated GFR was found to be significantly associated with faltering of height and hypertension. Preserving the renal function prevents growth faltering and development of hypertension at follow-up thereby ensuring a better quality of life.",
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Clinical Profile and Outcome of Children with Congenital Obstructive Uropathy. / Tangirala, Susmitha; Bhaskaranand, Nalini; Kini, Pushpa G.; Konda, Kalyan Chakravarthy; Gajjala, Sahithi Teja.

In: Indian Journal of Pediatrics, Vol. 86, No. 4, 10.04.2019, p. 354-359.

Research output: Contribution to journalArticle

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