CAKUT calculator: a clinical risk prediction tool for in-hospital mortality in neonates with congenital anomalies of the kidney and urinary tract admitted to level IV NICUs.

OBJECTIVE

To predict in-hospital mortality for infants with congenital anomalies of the kidney and urinary tract (CAKUT) using perinatal factors and use the resultant model to create an interactive clinical risk calculator.

STUDY

DESIGN

A retrospective cohort study included 13,233 neonates with CAKUT diagnoses admitted to forty-six level IV neonatal intensive care units participating in the Children's Hospitals Neonatal Consortium from 2010 to 2024. A predictive model for in-hospital mortality was built using perinatal risk factors.

RESULTS

1353 (10.2%) neonates died. Eight perinatal factors predicted mortality with strong model performance (area under the curve: 0.87 (95% confidence interval [CI]: 0.85, 0.88) training; 0.84 (95% CI: 0.82, 0.86) validation).

CONCLUSION

For newborn infants with CAKUT, prediction of in-hospital mortality can be estimated using 8 factors identifiable during the immediate perinatal period. Correspondingly, an on-line calculator that is publicly available for clinicians, researchers, and families of affected infants can be integrated in perinatal management.