Obstructive uropathy as a cause of renal failure in paediatric care unit in Egypt

ABSTRACT

Out of 245 infants and children admitted to the Pediatric Intensive Care Unit at the New Cairo University Children's Hospital because of renal failure, 40 [16.3%] cases were identified as having obstructive uropathy. They were 32 males and 8 females ranging in age from 20 days to 13 years which indicates a great delay in recognition of the obstructive uropathy in the majority of cases. Diagnosis of obstructive uropathy, its cause and site was based on sonographic scanning, plain x-ray abdomen, intravenous pyelography [when clinically indicated], ascending cysto-urethrogram, urinalysis and blood chemistry. The different causes of obstruction were urinary lithiasis [23 cases, 27.5%] posterior urethral valves [6 cases, 15%], bladder neck obstruction [2 cases, 5%], bilateral ureteric stricture [2 cases, 5%], pelviureteric junction obstruction [1 case, 2.5%], narrow ureteric orifices [1 case, 2.5%] and huge hydrocolpos obstructing both ureters [1 case, 2.5%]. Twenty-two [55%] patients were discharged with complete recovery of their renal function, 9 cases [22.5%] were discharged with chronic renal failure and 9 cases [22.5%] died. Our findings stress the importance of obstructive uropathy as a cause of renal failure in pediatric patients and confirm the value of ultrasound as an excellent screening procedure in such patients