№ 32General Pediatrics21 min read
Congenital malformations of the kidney and urinary tract
1. Big picture
Congenital malformations of the kidney and urinary tract are collectively called CAKUT: congenital anomalies of the kidney and urinary tract.
They are among the most important causes of:
- Antenatal hydronephrosis
- Recurrent urinary tract infection
- Vesicoureteral reflux
- Obstructive uropathy
- Hypertension
- Chronic kidney disease in children
The examiner wants you to think clinically:
Abnormal antenatal ultrasound → postnatal renal ultrasound → decide whether the child has obstruction, reflux, dysplasia, infection risk, or impaired renal function.
The two major pediatric exam patterns are:
-
Antenatal hydronephrosis
- Renal pelvis dilatation on fetal ultrasound.
- Main causes: transient dilatation, pelviureteric junction obstruction, vesicoureteral reflux, posterior urethral valves, duplex system, ureterocele.
-
Recurrent febrile UTI
- Must search for reflux, obstruction, renal scarring, and bladder dysfunction.
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