title: Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns.
abstract: BACKGROUND
  Congenital abnormalities of the kidney and urinary tract (CAKUT) are significant causes of morbidity. The aim of the study was to determine predictive factors of mortality in newborns with CAKUT.
  
  
  METHODS
  All 29,653 consecutive newborns hospitalized in a tertiary neonatal unit between 1996 and 2006 were evaluated. The main outcome was neonatal mortality. The variables analyzed as risk factors were maternal age, first pregnancy, low birth weight (LBW), prematurity, oligohydramnios, and CAKUT associated with other malformations (Associated CAKUT).
  
  
  RESULTS
  CAKUT was detected in 524 newborns, with an overall prevalence of 17.7 per 1,000 live births. A total of 325 (62%) cases were classified as urinary tract dilatation, 79 (15.1%) as renal cystic disease, and 120 (22.9%) as other subgroups. In the urinary tract dilatation subgroup, independent risk factors for early mortality were Associated CAKUT [odds ratio (OR) 20.7], prematurity (OR 4.5) LBW (OR 3.8), oligohydramnios (OR 3.0), and renal involvement (OR 3.0). In the renal cystic disease subgroup, two variables remained associated with neonatal mortality: LBW (OR 12.3) and Associated CAKUT (OR 21.4).
  
  
  CONCLUSIONS
  The presence of extrarenal anomalies was a strong predictor of poor outcome in a larger series of infants with CAKUT.
authors.affiliation: Division of Genetics, Department of Pediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.
authors.forename: Batielhe F
authors.initials: BF
authors.lastname: Melo
authors.forename: Marcos B
authors.initials: MB
authors.lastname: Aguiar
authors.forename: Maria Candida F
authors.initials: MC
authors.lastname: Bouzada
authors.forename: Regina L
authors.initials: RL
authors.lastname: Aguiar
authors.forename: Alamanda K
authors.initials: AK
authors.lastname: Pereira
authors.forename: Gabriela M
authors.initials: GM
authors.lastname: Paixão
authors.forename: Mariana C
authors.initials: MC
authors.lastname: Linhares
authors.forename: Flavia C
authors.initials: FC
authors.lastname: Valerio
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Simões E Silva
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Oliveira
mesh_terms: D001938:Brazil / Q000453:epidemiology; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000401:mortality; D007226:Infant Mortality; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging; D052177:Kidney Diseases, Cystic / Q000401:mortality; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016216:Ultrasonography, Prenatal; D014551:Urinary Tract / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000401:mortality*