నైరూప్య

Models predicting complication in congenital anomaly kidney and urinary tract

Oke Rina Ramayani, Yenita Djas, Rafita Ramayati, Putri Chairani Eyanoer*, Kiking Ritarwan

Objective: Children with CAKUT have difficult decisions about their prognosis. We developed end stage renal disease (ESRD) or mortality risk prediction models for children with CAKUT which included comorbidities, laboratories and measured of renal ultrasonography.

Material and methods: This is an observational, case and control study, involving 120 patients with CAKUT, who were divided into two groups type of CAKUT: the obstructive type and non-obstructive type. All patients were followed for at least 4 years. Detailed history of CAKUT and symptoms pointing to these diagnoses was obtained. Urine NGAL (uNGAL) and imaging studies (MCU and renal ultrasound) were performed for all of participants. Primary end point was a composite one that consisted of halving of eGFR or recurrent urinary tract infection. Secondary end points included ESRD (eGFR less than 15 ml/min/1.73 m2) or death caused by renal.

Results: The mean age of the patients was 7.5 ± 4.1 years and 60% were boys. Sixty two percents of patients had obstructive diagnosed of CAKUT. In bivariate analysis there was strong association between sex, type of CAKUT and uNGAL. After logistic regression, type of CAKUT andurin NGAL continued to be associated with ESRD or death. Based on regression equation then the risk prediction model for children with CAKUT are y=-4.787+3.012 × total score. Total score are defined based on type of CAKUT and classification level of uNGAL.

Conclusion: Type CAKUT and level uNGAL were found a significant number of CAKUT children who had progressively to ESRD. Therefore, we suggest that type CAKUT and level uNGAL could be considered in predicted worst complication in CAKUT patients.