| [ Summary ] |
Nearly 30％ of childhood cases of chronic renal failure are attributed to congenital anomalies of the kidney and urinary tract(CAKUT). For children with chronic renal failure arising from kidney, ureter and bladder anomalies, renal dysfunction is often advanced by the time they reach school age. Congenital anomalies cannot be detected at early ages using current urinary screening methods, because these methods rely on proteinuria and hematuria. Ultrasonography is effective for early detection of renal and urinary tract anomalies in prenatal and postnatal conditions. In the absence of systemic diseases, the prevalence of CAKUT is reported to be 0.1％ as determined through prenatal ultrasonography, and slightly over 1％ as determined by postnatal ultrasonography. Patients exhibiting any of the following diseases bilaterally warrant little prognostic optimism: severe vesicoureteral reflux (VUR), advanced hydronephrosis, small kidney (hypoplastic/dysplastic kidney) and multicystic dysplastic kidney. Conducting ultrasonographic screening in early infancy may permit early treatment to prevent renal insufficiency. However, there are some difficulties with screening such as timing, method and criteria for renal ultrasound, early detection of VUR, cost effectiveness, cost burden and collaboration with pediatric urologists. |