Congenital Anomalies of the Kidney and Urinary Tract: Clinical Presentation and Management

Clinical Presentation and Diagnosis

• Vesicoureteral reflux (VUR) is a urinary tract anomaly that can present with urinary tract infections, especially in children, according to the American College of Radiology 1
• Renal cortical scintigraphy (RCS) can be used to evaluate renal scarring in patients with CAKUT, as recommended by the American College of Radiology 1
• The American College of Radiology suggests that voiding cystourethrography (VCUG) can be used to detect vesicoureteral reflux in patients with CAKUT 1

Management Approach

• The American College of Radiology recommends antibiotic prophylaxis for vesicoureteral reflux to prevent recurrent UTIs in patients with CAKUT 1
• Surgical correction for obstructive lesions can be a treatment option for patients with CAKUT, according to the American College of Radiology 1

Urinary Tract Anomalies in Babies with Ear Skin Tags and Other Anomalies

Evidence Assessment and Clinical Approach

• The American Academy of Pediatrics recommends renal imaging when ear anomalies are accompanied by other malformations or dysmorphic features, such as facial asymmetry, eye abnormalities, or distal limb anomalies 2
• The presence of ear tags plus other anomalies warrants renal ultrasonography to evaluate for structural renal anomalies, and consideration of referral to urology if abnormalities are found 2
• Monitoring for signs of urinary tract infection is recommended for babies with ear tags, as it could be the first presentation of an underlying anomaly 3