Letter to the Editor

Abstract

Given the academic spirit of Colombia Médica, let us make some comments on the article «Unilateral renal agenesis: case review of ambulatory pediatric nephrology clinics in Cali, by Dr. Consuelo Restrepo de Rovetto et al.¹

As for the assertion «There are no national or local statistics in Colombia to know the frequency, clinical aspects and complications of this anomaly» even when it is true that in our country there is little information on the epidemiological behavior of this type of pathology, we have found in the literature two articles: one published by Zarante et al. in Biomédica in 2010 (published online since 01.09.09), which mentions a prevalence of unilateral renal agenesis of 0.94 per 10,000, in the evaluation of 52,744 births in four Colombian cities². Another article published by García et al.³ in the same journal in 2003, reported a prevalence of unilateral agenesis or kidney dysplasia of 1.76 per 10,000 births in the evaluation of 5686 births in Bogotá.

Additionally, in the results section «Single kidney associated to other pathologies was found in 46.5% cases: occult spina bifida and congenital scoliosis, three cases; anorectal malformations, 3 cases; chromosome syndromes, 2 cases; Klippel-Feil syndrome, two cases; cryptorchidie, 1 case; tricuspid insufficiency, 1 case; pre-auricular appendix in 1 case, and a case of morbid obesity.  No patient with myeloid-Vater sequence or meningocele was found», which states that no patients were found with a diagnosis of Vater sequence. We would like to clarify that the term Vater sequence is currently not appropriate and it has been replaced by the term VACTERL association from the acronym vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal malformations, and limb defects⁴. The term association refers to «the occurrence of multiple idiopathic congenital malformations during blastogenesis»⁵. Given this definition, and knowing that there are no minimum criteria for a diagnosis of VACTERL association⁶, we consider that the study presented four patients suspected of such association: patient 3, presented hemivertebrae; patients 18, 40, and 41 with anorectal malformation, requiring additional studies, including evaluation by a geneticist for a complete syndromic characterization that may impact on management and patient counseling.

Authors

• Paula Hurtado Universidad del Valle
• Harry Maurcio Pachajoa Universidad del Valle
• Consuelo Restrepo de Rovetto Universidad del Valle