Urinary Tract Disorders

Recurrent urinary tract infections (UTIs) are of particular concern in our population. UTIs were documented in more than 25% of DS adults, particularly those who are bedridden. Bladder neck resection is reported in 4/20 of the older DS adults and none of the younger group.

Mesangiocapillary glomerulonephritis, focal segmental glomerulosclerosis with hylanosis, acute glomerulosclerosis, minimal change disease, and membranous nephropathy causing renal failure are reported as occurring in DS [Gupta et al., 1991; Lo et al., 1998]. Among our adults, renal failure is
present in one. This is attributed to chronic, recurrent pyelonephritis.

Another man, a carrier of hepatitis B, has persistent proteinuria and haematuria with normal blood pressure. His clinical picture is attributed to minimal glomerular change disease associated with being a hepatitis B carrier. Hydronephrosis is documented in one patient. Other structural renal anomalies are not reported in our population; hoever, systematic renal ultrasound studies are not part of the routine yearly medical evaluations.

It is recommended that DS adults be assessed for structural renal anomalies with abdominal sonograms, along with routine monitoring for renal, and especially glomerular, disease [Lo et al., 1998].