Spectrum, management and outcomes of structural and functional uropathies in children attending a tertiary care center in karachi; pakistan

Causes and outcomes of children diagnosed with hydronephrosis in resource-limited countries with a low uti l i zati on of antenatal ul trasonography remai n unexpl ored. We performed a retrospecti ve, cross-sectional study of all paediatric patients diagnosed with hydronephrosis and managed at a tertiary care center in Karachi, Pakistan between 2005 and 2010. Data relating to demographics, cli nical features, etiol ogi es and treatment modalities were systematically collected. Of a total of 234 cases (74.4% male), 83 (35.5%) and 42 ( 17. 9%) were neonates and i nfants respecti vel y. Congenital urinary tract pathologies were noted in 192(72. 2%) pati ents, of whi ch onl y 96(50%) had undergone foetal ultrasonography and 77(40.1%) first presented after the age of 1 year. At a median follow-up of 4 years, 24(12.5%) of these patients had evidence of renal dysfunction. Worse urologic outcomes in this study were most likely attributable to delayed diagnosis of congenital urinary tract abnormalities.