Morphofunctional disorders of the cardiovascular system in cakutsyndrome in children

Abstract

BACKGROUND. Congenital abnormalities of the kidneys and urinary tract in children are included in the concept of CAKUT (con­genital anomalies of the kidney and urinal tract) - a syndrome and are often accompanied by changes in the cardiovascular system, which requires an interdisciplinary approach when observing them. THE AIM: to evaluate the nature and frequency of morphofunctional disorders ofthe cardiovascular system in children with CAKUT syndrome and optimize their medical follow-up. PATIENTS AND METHODS. 120 children were examined-90 with CAKUT syndrome (group 1) (24 - the doubling of the urinary tract, 36 - with congenital hydronephrosis, 30 - with polycystic kidney disease), and 30 practically healthy children (group 2). In group 1, there were 38 (42.2%) boys and 52 (57.8%) girls aged 4 to 16 years (average age 8±5.82 years), in group 2-13 (43.3%) boys and 17 (56.7%) girls aged 4 to 15 years (average age 6±6.73 years). A comprehensive examination of the urinary and cardiovascular systems was performed using ultrasound diagnostics and Holter monitoring of ECG and blood pressure. Statisti­cal processing was performed using the program "Statistica 8.0"("Stat Soft Inc., USA"). RESULTS. In CAKUT syndrome, often chronic infection was registered in children with a doubling of MVP (91.7%), hydronephrosis (88.9%). Persistent and increased crystalluria was observed in every third patient (33.3%) with a doubling of MVP, in 47.2% of children with hydronephrosis, and in almost 2/3 of patients (73.3%) with the polycystic disease. In children with CAKUT syndrome, congenital heart disease was de­tected in 15.0% of cases, with a high frequency of small heart abnormalities with a predominance ofthe left ventricular false chord (38.9%) and mitral valve prolapse (33.6%). CONCLUSION. The data obtained by us justify the need to include in the standard of dispensary observation of children with urinary tract congenital malformation examination by a pediatric cardiologist 1 -2 times a year with additional examination ofthe cardiovascular system (ECG, heart ultrasound, and daily blood pressure monitoring).