The follow up of children diagnosed congenital renal and urinary system anomalies prenatally or postnatally and the importance of prenatal diagnose

Congenital anomalies of kidney and urinary tract (CAKUT) are a major cause of morbidity in children and account for more than half of all renal failure cases in children and young adults. Since 1980s numerous anomalies have been detected in the fetus by integrating fetal ultrasonography into routine antenatal care. The aim of this study is to discuss the place and importance of prenatal diagnosis in CAKUT which have been diagnosed prenatally or randomly in any childhood period according to the results of prognosis of CAKUT cases.This study included 108 CAKUT cases whose ages were between 0 and 18 years, 76 of them were male (70,4 %) and 32 female (29,6 %). Hydronephrosis, the most common non-specific pathological finding, was seen in 46 of 58 prenatally diagnosed cases (composing Group 1) with prenatal ultrasonography. Ureteropelvic junction obstruction was seen in postnatal period in 26.1% of the hydronephrosis cases diagnosed prenatally. In Group 1 cases, 3 of 14 kidneys found normal postnatally out of 23 cases who had had prenatal US findings have APD ? 10 mm, and all the 5 kidneys having APD ? 10 mm had pathology in postnatal period. Among the reasons 50 cases in Group 2 (cases diagnosed at any time in postnatal childhood period) consulted to doctors, UTI diagnosis and UTI symptoms were the most common ones with 25 cases (50 %). Diagnosis ages in Group 2 were not classified with respect to the types of anomalies and the median was determined as 24 months. It was seen that 91.3 % of chronic kidney diseases, 91.7 % dialyzed patients, 85.7 % of transplanted cases and 60 % of exitus cases were in Group 2, that is these cases were seen mostly in postnatally diagnosed patients.In the light of the above mentioned results, diagnosing CAKUT cases prenatally and following them up carefully in early period will prevent manipulatable negative results such as CKD, HT, UTI and exitus.Key words: Congenital anomalies of kidney and urinary tract, prenatal ultrasonography, prognosis, chronic kidney disease