Endocrine Abstracts

Background: Several recent studies suggest that continuous low-dose antibiotics prophylaxis used in VUR may affect the growth of children. Guidos P.J. et al. (2018) found a significant increase in BMI in children who had prior antibiotic usage. CAKUT syndrome involves both the kidney and urinary tract and generally is associated with antibiotic therapy among pediatric patients and metabolism of waste products.

Aim: We aimed to evaluate the impact of congenital genitourinary defects (CAKUT syndrome) on BMI in pediatric patients compared to patients without structural pathology.

Materials and methods: We prospectively enrolled 49 pediatric patients admitted to the surgical and nephrological departments from June 1 to November 31, 2023. All patients were divided into two groups: study group (n=27) – CAKUT syndrome (VUR, PKD, horseshoe kidney, renal agenesis/hypoplasia, etc.) and prior/current episodes of CAP; control group (n=22) – UTI, without CAKUT (proved by US, VCUG or CT). All patients underwent complete work-up including clinical examination, evaluation of BMI according to WHO standards(underweight, healthy weight, overweight, obese, renal function tests (creatinine, urine, GFR), and imaging studies (US and/or VCUG/CT). Written informed consent was obtained from the parents. P<0,05 was considered significant.

Results: In the study group, 7.4% of patients were obese; 14.8% - overweight; 51.8% -healthy weight; 26% -underweight. BMI distribution in the control group: 4.5% -obese; 4.5% -overweight, 72.7% -healthy weight; 18.3% -underweight. We observed no significant risk of obesity (OR=1.68; 95% CI 0.1422 to 19.8541; P=0.06805), being overweight (OR=3.6522; 95% CI 0.3774 to 35.3435; P=0.2633) or underweight (OR=1.575; 95% CI =0.3948 to 6.2839; P=0.5199) among children with CAKUT syndrome comparing to their peers without congenital defects of urinary system.

Conclusion: CAKUT syndrome does not affect pediatric BMI. There is the same risk of being obese, overweight, or underweight among children with and without congenital defects of urinary system and UTI.