title: Urological anomalies and chronic kidney disease in children with anorectal malformations.
abstract: BACKGROUND
  This study aims to predict risk factors for urological anomalies in children with anorectal malformations (ARM) and describes the clinical features of patients who have developed chronic kidney disease.
  
  
  METHODS
  We retrospectively reviewed infants with ARM who received surgery and were followed at the Sabah Women and Children's Hospital, Malaysia, from 1986 to 2010.
  
  
  RESULTS
  One hundred and twenty-two children with anorectal malformations were studied, after excluding 24 children with incomplete data. Three factors were significant as predictors of the presence of a urological anomaly: high ARM lesion (OR 3.12, 95%CI 1.1-8.9), the presence of genital abnormality (OR 2.95, 95%CI 1.10-7.91) and cloacal anomaly in girls (OR 8.27, 95% CI 1.91-35.6). The most common anomalies were vesicoureteric reflux, single kidney and neurogenic bladder. Chronic kidney disease (CKD) was noted in 5.7%, in children who had recurrent urinary tract infections, neurogenic bladder or complex renal tract pathology; end-stage renal failure was seen in only 0.8% of children with ARM.
  
  
  CONCLUSIONS
  Urological anomalies were seen in 23% of patients, but the overall incidence of CKD and end-stage renal disease is low. Early identification of infants with ARM at risk of renal failure may be important for renal survival.
authors.affiliation: Paediatric Nephrology Service, Department of Paediatrics, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, 298090, Singapore. Indra.Ganesan@kkh.com.sg
authors.forename: Indra
authors.initials: I
authors.lastname: Ganesan
authors.forename: Shunmugam
authors.initials: S
authors.lastname: Rajah
mesh_terms: D000293:Adolescent; D000071056:Anorectal Malformations; D001006:Anus, Imperforate / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D014551:Urinary Tract / Q000002:abnormalities*