Korean Journal of Pediatrics 2009;52(4):464-470.
Published online April 15, 2009.
Incidence and outcome of congenital anomalies of the kidney and urinary tract detected by prenatal ultrasonography: a single center study
Gina Lim1, Joo Hoon Lee1, Young Seo Park1, Kun Seok Kim2, Hye-Sung Won3
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Department of Obstetric-Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
산전 초음파로 발견된 선천성 신 요로 기형의 발생률과 임상 결과: 단일 기관 연구
임진아1, 이주훈1, 박영서1, 김건석2, 원혜성3
1울산대학교 의과대학 서울아산병원 소아과학교실
2울산대학교 의과대학 서울아산병원 비뇨기과학교실
3울산대학교 의과대학 서울아산병원 산부인과학교실
Correspondence: 
Young Seo Park, Email: 1
Abstract
Purpose
: This study assessed the incidence and outcome of congenital anomalies of the kidney and urinary tract (CAKUT) detected by prenatal ultrasonography
Methods
: There were 906 cases of CAKUT detected by prenatal ultrasonography and postnatally confirmed at the Asan Medical Center from October 1989 to October 2007. We investigated the incidence and outcome of these cases by reviewing medical records retrospectively.
Results
: The order of incidence was hydronephrosis, multicystic dysplastic kidney (MCDK), duplex kidney, vesico-ureteral reflux (VUR), single kidney, hydroureteronephrosis, ectopic kidney, polycystic kidney, ureterocele, and posterior urethral valve (PUV). There were 520 cases (57.4%) of hydronephrosis, and 20% of these needed an operation due to significant obstruction. MCDK was associated with other CAKUT in 25.4% of all cases. Approximately 57.9% of duplex kidney cases needed surgical treatment due to ureterocele and VUR. VUR had a male: female ratio of 10:1. Two out of seven cases of autosomal recessive polycystic kidney had progressed to chronic renal failure. Patients with PUV were relatively uncommon, and one out of nine cases progressed to end-stage renal disease.
Conclusion
: CAKUTs detected by prenatal ultrasonography were composed of various anomalies, and almost all of them had a good outcome without any intervention. However, in some cases, recurrent urinary tract infection or renal failure occurred, especially in bilateral cases. For further management, a long-term multicenter study is needed to investigate the precise incidence and outcome of each anomaly in the general population.
Key Words: Congenital anomalies of the kidney and urinary tract, Prenatal ultrasonography, Incidence, Outcome


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