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Children with Down syndrome had increased risk for renal, urinary tract anomalies
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The prevalence of renal and urinary tract anomalies was four to five times higher among children with Down syndrome compared with children in the general population, data from a large retrospective cohort study indicated, prompting researchers to call for early screening in these newborns.
“Early renal ultrasound studies may be useful in detecting many of these anomalies and may allow for earlier diagnosis and treatment to reduce morbidity in the Down syndrome population,” wrote researchers from the Maimonides Infants and Children’s Hospital in Brooklyn and the New York State Department of Health in Troy.
A comparison of 3,832 children with Down syndrome and 3,411,833 healthy children revealed that renal and urinary tract anomalies occurred in 3.2% of children with the disorder compared with 0.7% of children without and included anterior urethral obstruction, cystic dysplastic kidney, hydronephrosis, hydroureter, hypospadias, posterior urethral valves, prune belly syndrome and renal agenesis.
Risk for ectopic kidney and ureteropelvic junction obstruction was similar between the two groups.
“Morbidity related to renal and urinary tract anomalies in patients with Down syndrome may be significant,” the researchers wrote. “Children may need to undergo a variety of radiologic and urodynamic studies for diagnostic purposes, as well as multiple urologic procedures to correct congenital urinary anomalies, including bladder augmentations, vesicostomies and cutaneous ureterostomies.”
Data were obtained from the New York State Congenital Malformation Registry, one of the largest population- based birth defect registries in the country. This is the first population-based report to specifically examine the incidence of these defects in children with Down syndrome, according to the researchers.
Kupferman JC. Pediatrics. 2009;124:e615-e621.