Outcome of Patients having Congenital Anomalies of the Kidney and Urinary Tract Associated with Congenital Heart Diseases in Pediatric Cardiac ICU.

Document Type : Original Article

Authors

1 Department of Pediatrics, Pediatric Nephrology Unit, Faculty of Medicine, Cairo University.

2 Department of Pediatrics, Pediatric Cardiology Unit, Faculty of Medicine, Cairo University.

3 Department of Pediatrics, Military Hospital Ghamra.

Abstract

Introduction: Congenital heart defects are the most common of all congenital malformations and there is a higher incidence of urinary tract anomalies in these cases 
Aim of the study: Our study aims to identify the prevalence and phenotypes of congenital anomalies of the kidney and urinary tract (CAKUT) among cases with congenital heart diseases admitted to cardiac ICU.
Methods: Eighty seven neonates and infants with congenital heart diseases were admitted to the cardiac ICU. Patients were assessed for CAKUT mainly via pelvi-abdominal US screening to exclude gross anomalies, along with clinical, laboratory and other imaging findings during the PICU admission. 
Results: Patients diagnosed with CAKUT formed 9.2%. Although there was no statistical correlation between certain types of congenital heart diseases (CHD) and certain types of CAKUT, there was a higher incidence among patients with cyanotic CHD (11.3%) rather than in patients with acyanotic heart CHD (6.9%). There was a strong correlation between the presence of CAKUT and the length of PICU stay, the need for higher doses of inotropes and the need for renal dialysis. There was a higher incidence with positive history of maternal chronic illness and maternal drug intake during pregnancy.
Conclusion: CAKUT is common among patients admitted into the PICU with CHD. CAKUT is associated with increased morbidity, length of PICU stay and poor outcome. Pelvi-abdominal US is one of the gold standard tools for screening.
 

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