Congenital Anomalies of the Urinary System among Sudanese on Hemodialysis at Gezira Hospital for Renal Diseases and Surgery, Gezira State, Sudan; 2018: Sonographic Study

Author(s): Taha Ahmed Elmukashfi, Mohamed AbdelSalam Nurein, Mustafa Omran Mansour

Congenital anomalies of urinary system are of wide spectrum ranging from mild, asymptomatic malformations to severe fatal conditions. To investigate occurrence of congenital anomalies in urinary system. It was a cross-sectional study. Study populations were Sudanese patients with ESRD on regular hemodialysis attending Gezira Hospital for Renal Diseases & Surgery, Gezira State, Sudan. Independent variables were horseshoe kidney, polycystic kidney disease, double ureter or ureteral duplication, ureteropelvic junction obstruction, posterior urethral valves, hypogenesis, agenesis, and kidney position. Dependent variable was hemodialysis. Investigation was done using abdominal ultrasound. Personal data was obtained using a questionnaire. Data was analyzed using SPSS version 21. P-value ≤ 0.05 was considered statistically significant. Results: Thirty one (62%) of respondents was male. Minimum age was 19 years while maximum age was 70 years. Maximum affected age group was age group (36-45) years; followed by age groups (46-55) and (56-65) years. Minimum age at which disease was diagnosed was 13 years. Overall prevalence was 12%. Four types of congenital anomalies were encountered and these are: polycystic kidney disease, uretero-pelvic junction obstruction, hypogenesis, and agenesis. Minimum disease duration was 1 year while maximum duration was 16 years. Mean duration was 6.42 years. Gender distribution of these types was as follows: Male (Two cases of polycystic kidney disease, one case of ureteropelvic junction obstruction, and one case of agenesis); female (one case of polycystic kidney disease, and one case of hypogenesis). Duration of disease is higher among male. Conclusion and recommendation: The current study highlighted a significant statistical relationship of the congenital anomalies in the urinary system among respondents and duration of ESRF. Screening for presence of congenital anomalies of renal system among general population of Central State may be of great help.

Congenital Anomalies of Renal System, ESRD, Sudanese Patients

1. Alpay H, Yildiz N, Altuntas U, Deniz NÇ & Gokce I 2013, Renal Abnormalities in Family Members of Individuals with CAKUT. Nephrology Dialysis Transplantation 28 (Supplement 1): i62, https://doi.org/10.1093/ndt/gft171
2. Banaga ASI, et al. 2015, Causes of end stage renal failure among haemodialysis patients in Khartoum State/Sudan. BMC Res Notes, 8: 502. doi: 10.1186/s13104-015-1509-x. PMCID: PMC4589074, https://doi.org/10.1186/s13104-015-1509-x
3. Briones JR, Pareja RR, Martín FS, Toniolo GC, Pérez JH, Mavrich HV 1998, Incidence of Tumoural Pathology in Horseshoe Kidneys, Eur Urol, 33:175–179. https://doi.org/10.1159/000019551
4. EBSCO 2016, Chronic kidney disease (CKD) in adults, viewed 4 October 2016, http://www.dynamed.com/topics/dmp~AN~T115336/
5. Elamin AEM, Mohammed NAA & Modawe G 2012, Aetiology of End-Stage Renal Disease among adult Sudanese patient, Sudan JMS, Volume 7, Number 4, 255-258 7.
6. Elsharif ME & Elsharif EG 2011, Causes of End-Stage Renal Disease in Sudan: A Single-Center. Saudi J Kidney Dis Transpl; 22(2):373-376 9.
7. Fernbach SK, Feinstein KA, Spencer K & Lindstrom CA 1997, Ureteral Duplication and Its Complications, RadioGraphics, Scientific Exhibit Volume 17 Number 1; 17:109-127
8. https://doi.org/10.1148/radiographics.17.1.9017803
9. Gatti JM & Cendron M 2017, Ureteral Duplication, Ureteral Ectopia, and Ureterocele, Medscape. 13.
10. Grampsas SA, et al. 2000, Anatomic and metabolic risk factors for nephrolithiasis in patients with autosomal dominant polycystic kidney disease. American Journal of Kidney Diseases, Volume 36, Issue 1, Pages 53-57. https://doi.org/10.1053/ajkd.2000.8266
11. Halvorson CR, Bremmer MS & Jacobs SC 2010, Polycystic kidney disease: inheritance, pathophysiology, prognosis, and treatment, International Journal of Nephrology and Renovascular Disease, 3, 69–83. https://doi.org/10.2147/ijnrd.s6939
12. Hansen, K.L, Nielsen, M.B. and Ewertsen, C. (2016). Ultrasonography of the Kidney: A Pictorial Review. Diagnostics 2016, 6, 0000 19.
13. Ilyas M, Hypertension in Adults: Part 1. Prevalence, types, causes and effects, SSMJ, Vol 2, Issue 3. Downloaded from http://www.southernsudanmedicaljournal.com 21.
14. Ojha P and Prakash S 2016, Unilateral incomplete duplicated ureter – A clinical and embryological insight, International Journal of Medical Research & Health Sciences, 5, 8:68-70. ISSN No: 2319-5886 23.
15. Polycystic Kidney Disease Foundation; 8330 Ward Parkway, Suite 510, Kansas City, MO 64114; (800) PKD-CURE; www.pkdcure.org
16. Rodriguez MM 2014, Congenital Anomalies of the Kidney and the Urinary Tract (CAKUT); Fetal and Pediatric Pathology, 33:293–320 ISSN: 1551-3815 print / 1551-3823 online. https://doi.org/10.3109/15513815.2014.959678
17. Sadler T.W. (2012). Langmans Medical Embryology. (12th edition). Twin Bridges, Montana (pp. 232 - 240) 29.
18. Shaheen FAM and Al-khader AA 2005, Preventive strategies of renal failure in the Arab world. Kidney International, Vol. 68, Supplement 98, pp. S37–S40. https://doi.org/10.1111/j.1523-1755.2005.09807.x
19. The Kidney Foundation of Canada. http://www.kidney.ca
20. Yosypiv IV 2012, Congenital Anomalies of the Kidney and Urinary Tract: A Genetic Disorder? International Journal of Nephrology, Volume 2012, Article ID 909083, 10 pages, https://doi.org/10.1155/2012/909083