A Review of Common Congenital Anomalies of the Kidneys and Urinary Tract: From Antenatal Diagnosis to Postnatal Follow-up

Anomalies of the fetal kidneys and urinary tract are one of the most common groups of structural abnormalities discovered on routine antenatal imaging. In select cases, these anomalies represent serious medical conditions that can have varying consequences, from recurrent urinary tract infections to renal scarring and even childhood end stage renal disease. It is therefore important to differentiate which findings on antenatal ultrasound will require further evaluation and possible postnatal treatment. The finding of any urogenital abnormality warrants a detailed ultrasound to evaluate both for additional urologic abnormalities as well as for other structural anomalies. This review will focus on the antenatal diagnosis and postnatal management of several of the most common congenital anomalies of the kidney and urinary tract, as well as some of the more controversial aspects of diagnosis and follow-up in these conditions. In addition, the importance of a cooperative team approach in the care of these patients is emphasized. Often recommendations for surveillance and treatment will be individualized based upon the presumptive antenatal diagnosis. Therefore, it is critical to maintain communication between practitioners who diagnose prenatally, those who will make decisions on surveillance and treatment in the postnatal period, and our patients.