Table 3.
Environmental risk factors for CAKUT
| Environmental Factors | CAKUT Phenotypes |
|---|---|
| Maternal diet | |
| Folic acid use (47) | Duplex collecting system, VUR, PUV |
| Low folate (46) | UPJO, renal agenesis, renal cysts |
| Vitamin A deficiency (43,44) | VUR, renal hypoplasia, renal dysplasia |
| Maternal conditions | |
| Maternal obesity (48) | Duplex collecting system, VUR |
| Maternal diabetes (40) | Wide range of CAKUT phenotypes including kidney abnormalities and outflow tract |
| Maternal malnutrition (38) | Low nephron number, low birth weight |
| Maternal substance use | |
| Maternal cocaine (45) | Horseshoe kidney, renal hypoplasia, renal dysplasia, duplex collecting system, VUR |
| Maternal alcohol (41) | Fetal alcohol syndrome, renal hypoplasia, kidney insufficiency |
| Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (47) | Acute kidney injury, renal hypoplasia |
| In vitro fertilization (48) | UPJO, duplex collecting system, PUV, VUR |
CAKUT, congenital anomalies of the kidneys and urinary tracts; VUR, vesicoureteric reflux; PUV, posterior urethral valve; UPJO, ureteropelvic junction obstruction.