CONGENITAL ANOMALIES OF THE KIDNEY AND URINARY TRACT IN CHILDREN IN TWO HOSPITALS IN DOUALA CAMEROON

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https://storage.unitedwebnetwork.com/files/1099/0d90306a3a672b349cb223917b1444f3.pdf

Abstract Title

First Name *

Beatrice

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Kaptue Motue Epse Moudze

Co-author 1

Ngo Mandeng Agathe Olive agatheolive00@gmail.com Mountain University (UdM) Pediatrie Banekane

Co-author 2

Marie Patrice Halle mariehalle28@gmail.com Faculty of Medicine and Pharmaceutical Science of Douala Nephrology Douala

Co-author 3

Fotsing Kwetche Pierre René prfotsingk@gmail.com Mountain University (UdM) Medecine Banekane

Co-author 4

Guemkam Georgette guemgeorg@hotmail.com Mother and child center Chantal Biya Foundation Pediatrics Yauonde

Co-author 5

Eposse Charlotte eekoubec@yahoo.fr Faculty of Medicine and Pharmaceutical Science of Douala Pediatric Douala

Co-author 6

Mbono Ritha mbonobetoko@yahoo.fr Faculty of Medicine and Pharmaceutical Science of Douala Pediatric Douala

Co-author 7

Hassanatou Iyawa Ousmanou hassanatouiyawa@gmail.com Faculty of Medicine and Pharmaceutical Science of Douala Pediatric Douala

Co-author 8

Hapi Fossi Mireille fossimireillearlette@gmail.com Laquintinie Hospital of Douala Pediatric Douala

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Congenital anomalies of the kidney and urinary tract (CAKUT) result from dysmorphogenesis of the kidneys and urinary tract.They are the main cause of chronic kidney disease(CKD) in children leading to end stage real failure (ESRF).This study set out to determine the prevalence of CAKUT and outcome in children in Douala.

Methods

We conducted a descriptive ,retrospective study over a nine years period from 1st January 2014 to 31 July 2023 at two referral hospitals in the city of Douala in pediatric and urologic unit.Our study included children aged from 0 to 18 years old with radiologically confirmed congenital anomalies of the kidney and urinary tract(CAKUT).The variables studied were:socio demographical, clinical, therapeutic method and outcome patients.

Results

A total of 73 children were included.The hospital prevalence was 0,28%,with male preponderance (84,9%).Ante-natal diagnostic was made in 17 children(23,2%).The median age of diagnostic was 8 months.The main malformations were:posterior urethral valves 64,4%(n=47),unilateral renal agenesis 12,3%(n=9),multicystic renal dysplasia 11%(n=8) and ureteropelvic junction obstruction 9,6%(n=7).Recurrent urinary tract infection was among the main circumstance of discovery 47,9%(n=35),while growth retardation was among the main physical sign in 32,9%(n=24).Post natal ultrasound was performed in all children (n=73,100%) and retrograde urethrocystography in all children who had indication (n= 47, 100%). Surgery were performed in 29 of 54 patients (53,7%);9 children progressed to ESRF with 4 (44,4%) on dialysis.The over all mortality rate was 16,4% (n=12).Factors associated with mortality were: age less then one month (p 0,01),Stage II to IV CKD (p 0,046),ESRF (p 0,035) ,metabolic acidosis(p 0,035),proteinuria (p 0,046). The one year survival rate was 75% while 25 (34,2%) children were lost to follow up.

Conclusions

The prevalence of CAKUT in our study was low at 0,28% with posterior urethral valve being the commonest malformation.Ante natal diagnostic was low in 23% and median age of diagnostic was late(8 months).Recurrent urinary tract infection was among the main circumstance of discovery(47,9%).Surgery rate was medium (53,7%).Antenatal diagnostic needs to be improved for better early care to prevent or slow down an evolution toward CKD.Long term postoperative follow up must be insured to avoid losing sight of the patients.

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