Risk factors and the likelihood of acute renal failure in children with congenital malformations of the urinary system

The article presents a retrospective analysis of anamnestic and clinical and laboratory data of 42 case histories of children treated in the neonatal pathology department from 2015 to 2019. The study group of newborns had congenital malformations of the urinary system (CAKUT), the rest of the children made up the control group. The study was carried out on the basis of the regional perinatal center in Kursk. A comprehensive assessment of risk factors for the occurrence of malformations of the urinary system in newborns, a study of renal function in this group of patients using physical, laboratory and instrumental examinations, indicating the presence or absence of acute renal failure (ARF), was carried out. All newborns from the moment of birth to discharge from the hospital were under dynamic observation, the data of which were studied retrospectively from the records in the clinical history of the disease. The main indicators that were most thoroughly studied during the analysis were those that reflect the condition of the child in the presence of congenital malformations of the urinary system and satisfy the criteria for the diagnosis of acute renal failure. The data of obstetric and gynecological history of mothers, the presence of concomitant pathology in newborns, Apgar score at birth, clinical manifestations of renal failure (presence of pastiness, edema, microcirculation disorders, etc.), birth weight, general blood test data were analyzed urine, biochemical blood test, acid-base state for the first 7 days of life. The study identified the main risk factors leading to the development of congenital malformations in CAKUT (chorioamnionitis, intrauterine infection in early gestation, gestational arterial hypertension, toxoplasmosis, rubella, transferred during pregnancy), and also assessed the likelihood of developing acute renal failure in this category of newborns. 

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