Evaluation of congenital anomalies of the kidney and urinary tract (CAKUT)
- Norman D Rosenblum, MD, FRCP
Norman D Rosenblum, MD, FRCP
- Professor of Pediatrics
- University of Toronto
- Section Editors
- Tej K Mattoo, MD, DCH, FRCP
Tej K Mattoo, MD, DCH, FRCP
- Section Editor — Pediatric Nephrology
- Professor of Pediatrics
- Wayne State University School of Medicine
- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr., MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
Congenital anomalies of the kidney and urinary tract (CAKUT) constitute approximately 20 to 30 percent of all anomalies identified in the prenatal period . Routine antenatal ultrasonography during pregnancy detects the majority of CAKUT.
Antenatal screening for CAKUT and the postnatal evaluation of infants diagnosed prenatally with CAKUT are discussed here.
The majority of renal malformations are detected antenatally because of the widespread use and sensitivity of fetal ultrasonography. In 2002, a prenatal ultrasound was performed in about two-thirds of all live births in the United States. The frequency of congenital anomalies of the kidney and urinary tract (CAKUT) as detected sonographically in unselected populations has been reported to be between 0.1 to 0.7 percent [2-4].
In general, the optimal timing recommended for a screening antenatal ultrasound is between 16 to 20 weeks of gestation because of the following factors at this gestational age:
●There is good visualization of anatomy with a high sensitivity in detecting anomalies.
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- ANTENATAL SCREENING
- Fetal kidney
- Amniotic fluid
- - Volume
- - Analysis
- - In utero intervention
- POSTNATAL EVALUATION
- History and physical examination
- Timing of postnatal renal studies
- Other diagnostic tests
- - Serum creatinine
- - Voiding cystourethrography
- - Dynamic renal scan
- - Static renal scan
- - Serial ultrasound
- INFORMATION FOR PATIENTS