P318 The nexus between chronic kidney disease and urinary tract infections

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Abstract

Background and aims

Congenital anomalies of the kidney and urinary tract (CAKUT) represent an important segment of the renal pathology, and the prevalence in the paediatric patients is growing. CAKUT is frequently associated with recurrent urinary kidney infections (UTI) which in time might accelerate the progression towards chronic kidney disease (CKD).

Background and aims

The study aims to label CAKUT incidence in paediatric patients and the prevalence of UTI associated to congenital malformation of the kidney.

Methods

The cross-sectional retrospective study was finished in a period of 3 years (1 January 2012 – December 31, 2014) in the Emergency Hospital for Children,Louis Turcanu’’.

Methods

The initial batch included 112 patients with CAKUT. Besides, taking in to consideration the location of the kidney abnormality, patients were divided into two study groups: 84 patients (75%) were diagnosed with urinary tract and bladder malformations and 28 patients (25%) were identified with renal parenchyma abnormalities. The of evolution and prevalence of UTI and the appearance of CKD were studied in both groups.

Results

CAKUT incidence among patients hospitalised in the our hospital in the period of the study was 6%, including 75% was represented by renal tract abnormalities and urinary bladder.

Results

Regarding the first group of study, including abnormalities tract renal and urinary bladder of all patients, 37% were diagnosed with hydronephrosis, 20% with vesicoureteral reflux, 14% with pyeloureteral stenosis, with megaureter 13%, 6% with cloacal exstrophy, 5% of pielocaliceal stenosis and pielocaliceal bifidity. In the second study group, patients diagnosed with abnormal renal parenchyma, 46% were diagnosed with kidney agenesia, 25% with renal hypoplasia, 21% with renal dysplasia, 4% with kidney malrotation and 4% of ectopic kidney.

Results

The most common complication of CAKUT is represented by UTI, with an incidence of 22%. In 62% of cases occurred amid UTI abnormalities of the urinary tract and bladder. Assign cause of CKD based on presence or absence of systemic disease and the location within the kidney of observed or presumed pathologic anatomic findings was 10% amongst 54% developing CKD and renal parenchimal abnormalities develop CKD 46% regarding urinary tract and abnormalities of the bladder.

Conclusions

The diagnosis and management of UTI is crucial in the evolution of the instances. CAKUT represent the most important cause of UTI, that in return if neglected can lead to CKD, thus a vicious circle is created between renal malformation, UTI and CKD.

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