Patterns and Clinical Outcomes of Congenital Anomalies of the Kidney and Urinary Tract in Preterm Infants.

Introduction Congenital anomalies of the kidneys and urinary tract (CAKUT) are embryonic disorders that arise during development and result in a spectrum of defects in the kidneys and outflow tracts, which include the ureters, the bladder, and the urethra. The clinical spectrum ranges from severe malformations, such as renal agenesis, to potentially milder manifestations, such as vesicoureteral reflux. CAKUT are the leading cause of kidney failure in children and one of the most common indications for kidney transplantation. Purpose This research aims to determine the pattern of CAKUT in preterm infants in Qatif Central Hospital, located in Qatif, which is in the eastern region of Saudi Arabia. Methods This cross-sectional study was performed to determine the pattern of CAKUT using ultrasound in neonates admitted to the neonatal intensive care unit (NICU) in Qatif Central Hospital in the Eastern region of Saudi Arabia between January 2018 and December 2022. Eligible participants were infants born at 23 to less than 37 weeks' gestation. All neonates aged between one and 28 days of either gender admitted to the NICU with a postnatal diagnosis of congenital renal anomalies on an anomaly scan were included in the study. Results The presence of anomalies of the kidneys, ureters, bladder, or urethra was assessed and analyzed in a cross-sectional single-center study. Among the 48 patients, 30 (62.2%) were male and 18 (37.5%) were female, with a mean (SD) gestational age of 32.5 ± 3.5 weeks, and the majority of them had low birth weight (29, 60.4%). The most common findings related to CAKUT were hydronephrosis. The presence of CAKUT correlated with male gender, congenital heart disease, lung anomaly, and genetic disorders (p = <0.05). Conclusion The findings of this study suggest that clinicians caring for preterm infants should have a higher suspicion for CAKUT and consider screening, particularly those with extrarenal anomalies or genetic disorders, as preterm infants with CAKUT appear to be at significantly higher risk of death or severe illness. Detection of CAKUT can inform risk stratification and clinical decision-making and should also prompt clinicians to consider a genetic evaluation.