Congenital anomalies of the kidney and urinary tract in children treated at a tertiary hospital in Northern Tanzania: assessment of coexisting congenital anomalies

Background: A high burden of complications, including death, among children with congenital anomalies of the kidney and urinary tract (CAKUT) has been reported in African settings. We aimed to determine the pattern, age at diagnosis, and presence of coexisting anomalies in CAKUT in children at a tertiary referral hospital in northern Tanzania. Methods: A hospital-based retrospective study was conducted that retrieved data for children aged below 18 years who attended the urology clinic between January 2018 and December 2024. Variables from their clinical history, laboratory, and imaging investigations, including voiding cystourethrogram, transabdominal ultrasound, and CT, were extracted. Results: Of the 2214 children reviewed, 493 (22%) were diagnosed with CAKUT. The median age at presentation was 3 years (IQR 1-6). Of these, 60% had anomalies of the urethra, especially hypospadias and posterior urethral valves. This was followed by anomalies of the kidney (in 26% of 493), in which either a single kidney or ectopic kidneys were frequently diagnosed. The majority of children diagnosed with CAKUT had coexisting anomalies (67%). Most coexisting anomalies were genital malformations (24%). Conclusion: A high proportion of CAKUT is seen among children referred to the urology clinic of a tertiary referral hospital in northern Tanzania. The majority of children with CAKUT present late. Most are diagnosed with anomalies of the urethra and kidneys. Common coexisting anomalies are of the genitalia.