Congenital renal agenesis: Case-control analysis of birth characteristics

doi:10.1053/ajkd.2002.31982

American Journal of Kidney Diseases

Volume 39, Issue 4, April 2002, Pages 689-694

https://doi.org/10.1053/ajkd.2002.31982 Get rights and content

Abstract

Renal agenesis (RA) is the most common congenital urinary malformation; however, evidence for prenatal factors associated with the development of this condition is limited. The aim of this study is to determine prenatal and perinatal factors associated with the development of RA. We performed a case-control study of Colorado births with RA from 1989 to 1998 identified in the Colorado Responds for Children With Special Needs and linked with birth certificate data. There were 189 infants with RA and 940 control infants without RA on the study. The incidence of RA is approximately 1 per 2,900 births. Seventy-six infants (40.6%) born with RA were girls, and 111 infants (59.4%) were boys (P = 0.02). Preexisting diabetes mellitus in the mother was a significant factor associated with RA (adjusted odds ratio (OR), 4.98; 95% confidence interval (CI), 1.08 to 22.93) while controlling for maternal age, maternal race, and alcohol exposure. Black maternal race also was significantly associated with the development of RA (adjusted OR, 2.19; 95% CI, 1.26 to 3.95) while controlling for other factors. Maternal age younger than 18 years, maternal education less than 12 years, alcohol exposure, and infant sex approached significance. RA is a relatively common congenital malformation of the urinary tract. This condition appears to have a multifactorial cause, with a combination of genetic and environmental factors. Further research is needed to show a better understanding of these risk factors. © 2002 by the National Kidney Foundation, Inc.

Section snippets

Study population

We conducted a case-control study of Colorado births with RA by using the Colorado State Birth Registry and the CRCSN between 1989 and 1998. A case is defined as a live birth infant with RA using the International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code 753.0, as identified in the CRCSN database. The CRCSN database captures cases of RA in children up to 3 years of age.

A total of 551,285 births were reported from Colorado between 1989 and 1998. In these years, 189

Results

The birth prevalance of RA in Colorado from 1989 to 1998 was approximately 1 case per 2,900 live births in our study. Seventy-six cases (40.6%) were girls, and 111 cases (59.4%) were boys (P = 0.02). A greater proportion of case infants compared with controls had mothers who were 18 years or younger, black, and educated less than 12 years (Table 1).

. Maternal Demographics, Exposure, and Comorbid Disease Characteristics of Infants Born With RA and Controls, Colorado, 1989 to 1998

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Discussion

The incidence of RA in our study was approximately 1 in 2,900 births. The incidence reported in the literature varies significantly, from 1 case in 500 to 3,200 births. This discrepancy in the reported incidence may be related to sample sizes, diagnostic methods, and population or ethnic differences. This incidence has been stable over the last 10 years in Colorado. The incidence may be decreasing because despite improvement in diagnostic capabilities, the number of cases has remained stable.

Acknowledgements

The authors thank Dr Lisa Miller, Rickey Tolliver, and Russel Rickard from the Colorado Department of Health for help with access to the CRCSN and Colorado Birth Registry databases and Drs Ned Calonge and Dennis Lezotte for invaluable suggestions given during the study.

These data were supplied by the Colorado Department of Public Health and Environment, which specifically disclaims responsibility for any analyses, interpretations, or conclusions it has not provided.

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^*: Address reprint requests to Chirag Parikh, MD, Division of Renal Diseases and Hypertension, Box C-281, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Denver, CO 80262. E-mail: [email protected]

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Original InvestigationsCongenital renal agenesis: Case-control analysis of birth characteristics*,**

Abstract

Section snippets

Study population

Results

Discussion

Acknowledgements

Urology

Am J Kidney Dis

J Urol

Adv Pediatr

Cystic and developmental diseases of the kidney

Congenital unilateral solitary kidney. Report of 37 cases and a review of the literature

Urol Surv

Risk factors in internal urinary system malformation

Pediatr Nephrol

Renal involvement in heredo-familial and congenital disease

First trimester ultrasonographic diagnosis of fetal structural abnormalities in a low risk population

Br J Obstet Gynaecol

Original Investigations
Congenital renal agenesis: Case-control analysis of birth characteristics*,**