EFFECTS OF CONGENITAL ANOMALIES OF THE KIDNEY AND URINARY TRACT ON BLOOD PRESSURE AND RENAL FUNCTION IN CHILDREN: A HOSPITAL-BASED OBSERVATIONAL STUDY
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Keywords
CAKUT, Hypertension, Proteinuria, Serum Creatinine, Chronic Kidney Disease, Children.
Abstract
Background: Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) represent a heterogeneous group of developmental disorders involving the kidneys and urinary tract and are among the leading causes of chronic kidney disease (CKD) in children. Reduced nephron number, urinary tract obstruction, vesicoureteral reflux, and renal dysplasia predispose affected children to hypertension, proteinuria, and progressive renal dysfunction. Early identification of these complications is essential for preventing long-term renal and cardiovascular morbidity. Aim of the study to analyze the effects of congenital abnormalities of the kidneys and urinary tract on blood pressure and serum creatinine levels in children diagnosed with CAKUT.
Methods: A hospital-based observational study was conducted in the Department of Pediatrics at a tertiary care teaching hospital between April 2024 and September 2025. Children aged 1–15 years diagnosed with CAKUT were enrolled. Clinical evaluation included blood pressure assessment, serum creatinine estimation, estimated glomerular filtration rate (eGFR), and proteinuria evaluation. Statistical analysis included Chi-square testing, odds ratio estimation, and comparison of means.
Results: A total of 110 children were evaluated. Male predominance was observed (65.45%). Hypertension was present in 9.09% of patients, renal dysfunction in 11.82%, and proteinuria in 13.64%. Children with CAKUT demonstrated significantly higher odds of hypertension, elevated serum creatinine, and proteinuria. Renal dysfunction was present in 80% of hypertensive children compared with only 5% of non-hypertensive children (p<0.0001). Proteinuria showed the strongest association with CAKUT (OR=22.94; p=0.003).
Conclusion: CAKUT is strongly associated with proteinuria, renal dysfunction, and hypertension. Proteinuria appears to be an early marker of renal injury, while hypertension reflects more advanced disease. Regular monitoring of blood pressure, renal function, and urinary protein excretion is essential to improve long-term outcomes.
References
2. Stonebrook E, Hoff M, Spencer JD. Congenital anomalies of the kidney and urinary tract: clinical review. Curr Treat Options Pediatr. 2019;5(3):223-235.
3. Flynn JT, Kaelber DC, Baker-Smith CM, et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017;140(3):e20171904.
4. Walawender L, Szczepanska M, Szczepanski W. Congenital anomalies of the kidney and urinary tract: current concepts. Children (Basel). 2023;10(4):682.
5. Sanna-Cherchi S, Ravani P, Corbani V, et al. Renal outcome in patients with congenital anomalies of the kidney and urinary tract. Kidney Int. 2009;76(5):528-533.
6. Kumar BH, Suresh B, Reddy PR. Clinical profile of congenital anomalies of kidney and urinary tract in children. Int J Contemp Pediatr. 2019;6(4):1560-1566.
7. Ichikawa I, Kuwayama F, Pope JC, Stephens FD, Miyazaki Y. Paradigm shift from classic anatomic theories to contemporary cellular and molecular understanding of CAKUT. Kidney Int. 2002;61(3):889-898.
8. Nicolaou N, Renkema KY, Bongers EMHF, Giles RH, Knoers NVAM. Genetic, environmental and epigenetic factors involved in CAKUT. Nat Rev Nephrol. 2015;11(12):720-731.
9. Ishiwa S, Sanna-Cherchi S. Genetic basis of congenital anomalies of the kidney and urinary tract. Pediatr Nephrol. 2019;34(9):1503-1515.
10. Rodriguez MM. Congenital anomalies of the kidney and urinary tract (CAKUT). Fetal Pediatr Pathol. 2014;33(5-6):293-320.
11. Soliman NA, Ali RI, Ghobrial EE, Habib EI, Ziada AM. Pattern of congenital anomalies of the kidney and urinary tract in Egyptian children. Saudi J Kidney Dis Transpl. 2015;26(2):413-418.
12. Brenner BM, Garcia DL, Anderson S. Glomeruli and blood pressure: less of one, more the other? Am J Hypertens. 1988;1(4):335-347.
13. Charlton JR, Baldelomar EJ, Hyatt DM, Bennett KM. Nephron number and its determinants. Pediatr Nephrol. 2021;36(4):797-807.
14. Taha K, Catapang M, Becknell B, Matsell DG. Hypertension in children with congenital anomalies of the kidney and urinary tract. Pediatr Nephrol. 2024;39(4):1185-1192.
15. Westland R, Schreuder MF, Bökenkamp A, et al. Renal injury in children with a solitary functioning kidney. Nephrol Dial Transplant. 2011;26(5):1533-1541.
16. Warady BA, Abraham AG, Schwartz GJ, et al. Predictors of rapid progression of CKD in children. JAMA Pediatr. 2015;169(11):1015-1022.
17. van Biljon G, Meintjes CJ, Becker PJ, Karusseit VOL. Risk factors for progression of chronic kidney disease in children. Nephrology. 2023;28(5):276-282.
18. Mong Hiep TT, Ismaili K, Collart F, et al. Clinical characteristics and outcomes of children with chronic kidney disease. Pediatr Nephrol. 2010;25(5):935-940.
19. Kommareddy A, Vagha K, Vagha JD, et al. A Study of Clinical Profile of Congenital Anomalies of Kidney and Urinary Tract (CAKUT) in a Tertiary Care Center. Cureus. 2024 Jul 3;16(7):e63766.
20. Warady BA, Abraham AG, Schwartz GJ, et al. Predictors of Rapid Progression of Glomerular and Nonglomerular Kidney Disease in Children and Adolescents: The Chronic Kidney Disease in Children (CKiD) Cohort. Am J Kidney Dis. 2015 Jun;65(6):878-88.
21. Brenner BM, Garcia DL, Anderson S. Glomeruli and blood pressure. Less of one, more the other? Am J Hypertens. 1988 Oct;1(4 Pt 1):335-47.
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Dr. Rohit Suman
PG Resident, Dept. of Paediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur
Dr. Yashu Saini
Professor, Dept. of Paediatric Nephrology, Mahatma Gandhi Medical College and Hospital, Jaipur
Dr. Sunita Sattavan
Associate Professor, Dept. of Paediatric Nephrology, Mahatma Gandhi Medical College and Hospital, Jaipur
Dr. Rupesh Masand
Professor & Head, Dept. of Paediatrics, Mahatma Gandhi Medical College and Hospital, Jaipur
