Keywords: congenital urinary tract anomalies, general practice, parental awareness, screening, prevention, chronic kidney disease

Background:

Congenital anomalies of the urinary tract (CAUT) are a leading cause of chronic kidney disease (CKD) in early childhood. Early screening and follow-up are essential to prevent complications. In Bulgaria, GPs provide routine pediatric care and are central to implementing national prevention protocols. This study assesses parental awareness of CAUT and the role of GPs in facilitating early detection and monitoring.

Research questions:

To explore parental awareness of early signs of urinary tract infections (UTIs), potential complications, and the importance of screening for CAUT in young children.

Method:

This cross-sectional observational study was conducted in general practices where GPs provide ongoing pediatric care. Two parallel surveys were administered: one to 170 parents of children aged 0–3 years from GP lists, and another to 42 GPs performing pediatric consultations. Data collection included structured questionnaires assessing socio-demographic characteristics, parental knowledge and attitudes, and GP practices regarding CAUT screening. Statistical analysis was used to examine associations and indicator prevalence.

Results:

Only 20.6% of parents were aware of UTI risk factors, and 70.6% did not recognize possible complications. Among their children, 11.8% had diagnosed CAUT and 26.5% had experienced UTIs. Despite national guidelines, 10.6% of children had not seen a pediatric nephrologist by six months of age. Follow-up was required in 25.3% of nephrology visits. GPs reported detecting asymptomatic UTIs during routine check-ups in 75.6% of cases.

Conclusions:

Parental awareness of CAUT is insufficient. Strengthening GP-led education and screening within routine care may improve early diagnosis, reduce complications, and lower CKD risk in early childhood.

Points for discussion:

The importance of screening programs in general medical practice for the prevention of chronic diseases.

Parental awareness as part of early diagnosis and prevention of complications of chronic diseases.

Congenital anomalies of the urinaru trackt as a major factor in the development of chronic kidney disease, disability and early mortality.