Prevalence and Morphological Spectrum of Congenital Anomalies of the Kidney and Urinary Tract in Children Presenting with Urinary Tract Infections in Central India

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of pediatric chronic kidney disease and often first manifest as urinary tract infections (UTIs). Data regarding the exact prevalence and morphological spectrum of these anomalies in Central India are limited. The objective is to determine the prevalence and morphological pattern of CAKUT in children diagnosed with UTIs at a tertiary care center in Central India. Material and Methods: A hospital-based cross-sectional observational study was conducted over a year in the Departments of Paediatrics and Paediatric Surgery at a tertiary teaching hospital in Indore. Eighty children presenting with clinical and laboratory evidence of UTI were enrolled using consecutive sampling. Diagnostic evaluation included ultrasonography of the kidneys, ureters, and bladder (USG KUB), with micturating cystourethrogram (MCU) reserved for recurrent UTIs or abnormal sonographic findings. Results: CAKUT was identified in 23.8% of the cohort, with a striking predominance in neonates (100%) and infants (60.0%). Males were more frequently affected (60.0%). First-episode UTIs were noted in 88.8%, but recurrent UTIs were strongly associated with CAKUT (88.9%). Structural anomalies were present in 46% of children, with hydroureteronephrosis and high-grade VUR being the most common. All children with CAKUT needed long-term multidisciplinary follow-up. Conclusion: Almost one-quarter (24%) of pediatric patients with UTIs had CAKUT, especially younger children and those with recurrent UTIs, and early targeted imaging is important to prevent further renal damage.

Keywords: Congenital anomalies of the kidney and urinary tract; CAKUT; Urinary tract infection; Vesicoureteral reflux; Central India.