Marta Martins CARVALHO, Mariana Gouveia LOPES, Marta MACHADO, Catarina NEVES, Carolina CORDINHÃ, Carmen CARMO, Clara GOMES
The Journal of Pediatric Research - 2026;13(2):128-132
Aim: Congenital anomalies of the kidney and urinary tract (CAKUT) are a leading cause of chronic kidney disease in children. This study aimed to evaluate the frequency of adverse renal outcomes and also to identify early risk factors for guiding long-term follow-up strategies. Materials and Methods: We conducted a retrospective cohort study of children born between 2010 and 2023 with diagnoses of unilateral kidney agenesis, multicystic dysplastic kidney, or posterior urethral valves (PUV) followed up at a tertiary pediatric nephrology center. Clinical and demographic variables were extracted from the electronic health records. Adverse renal outcomes included proteinuria, hypertension and an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73m2 or age-equivalent thresholds. Univariate logistic regression analyses were performed in order to assess associations between potential predictors and adverse outcomes. Results: Among the 104 patients [60% male; median age at last follow-up 7.2 years (interquartile range 6.9)], 13% developed adverse renal outcomes, most commonly proteinuria (7%). The median age at onset of these outcomes was 3.7 years. PUV, prematurity and a history of urinary tract infection (UTI) were significantly associated with adverse outcomes. Other factors, including low birth weight, additional CAKUT, reduced baseline eGFR, and kidney length to body length ratio at diagnosis, were not significantly associated with negative outcomes. Conclusion: Adverse renal outcomes can occur early in children with CAKUT. Prematurity, UTI and PUV emerged as key determinants of adverse renal prognosis and may serve as valuable markers for identifying patients at higher risk who may require closer and more individualized follow-up.
