TY - JOUR
T1 - Severe fetal hydronephrosis
T2 - the added value of associated congenital anomalies of the kidneys and urinary tract (CAKUT) in the prediction of postnatal outcome
AU - Perlman, Sharon
AU - Roitman, Lucia
AU - Lotan, Danny
AU - Kivilevitch, Zvi
AU - Pode-Shakked, Naomi
AU - Pode-Shakked, Ben
AU - Achiron, Reuven
AU - Dekel, Benjamin
AU - Gilboa, Yinon
N1 - Publisher Copyright:
© 2018 John Wiley & Sons, Ltd.
PY - 2018/2
Y1 - 2018/2
N2 - Objective: The aim of this study was to focus on fetuses diagnosed with severe hydronephrosis and correlate prenatal sonographic characteristics with postnatal outcome. Methods: Cases presenting prenatally with severe hydronephrosis (anterior-posterior renal pelvic diameter >15 mm) were collected retrospectively over a period of 11 years and divided into 2 groups: (1) isolated hydronephrosis and (2) those associated with congenital anomalies of the kidney and urinary tract (CAKUT). Results: A total of 83 fetuses comprised the study group: 35 fetuses had isolated severe hydronephrosis and 48 had associated CAKUT. The mean anterior-posterior renal pelvic diameter was 22.6 ± 8.5 mm (range 15.0-66.0 mm). The CAKUT group was associated with a significantly increased incidence of postnatal need for surgery (17.6% vs 44.2%, P =.014), dysplastic kidney (0% vs 14%, P =.023), and total abnormal outcome (52.9% vs 86%, P =.001) in comparison with isolated severe prenatal hydronephrosis. Conclusions: Severe fetal hydronephrosis has a wide postnatal clinical spectrum, which is mainly influenced by the presence of associated sonographic CAKUT findings. These clinical data have biological relevance: a genetic or environmental defect that influences multiple renal developmental processes leads to hydronephrosis but also to concomitant malformations (CAKUT) and critically influences renal prognosis. A more selective abnormal developmental process that results in isolated enlarged pelvis even to a severe extent has less influence on renal prognosis.
AB - Objective: The aim of this study was to focus on fetuses diagnosed with severe hydronephrosis and correlate prenatal sonographic characteristics with postnatal outcome. Methods: Cases presenting prenatally with severe hydronephrosis (anterior-posterior renal pelvic diameter >15 mm) were collected retrospectively over a period of 11 years and divided into 2 groups: (1) isolated hydronephrosis and (2) those associated with congenital anomalies of the kidney and urinary tract (CAKUT). Results: A total of 83 fetuses comprised the study group: 35 fetuses had isolated severe hydronephrosis and 48 had associated CAKUT. The mean anterior-posterior renal pelvic diameter was 22.6 ± 8.5 mm (range 15.0-66.0 mm). The CAKUT group was associated with a significantly increased incidence of postnatal need for surgery (17.6% vs 44.2%, P =.014), dysplastic kidney (0% vs 14%, P =.023), and total abnormal outcome (52.9% vs 86%, P =.001) in comparison with isolated severe prenatal hydronephrosis. Conclusions: Severe fetal hydronephrosis has a wide postnatal clinical spectrum, which is mainly influenced by the presence of associated sonographic CAKUT findings. These clinical data have biological relevance: a genetic or environmental defect that influences multiple renal developmental processes leads to hydronephrosis but also to concomitant malformations (CAKUT) and critically influences renal prognosis. A more selective abnormal developmental process that results in isolated enlarged pelvis even to a severe extent has less influence on renal prognosis.
UR - http://www.scopus.com/inward/record.url?scp=85041647892&partnerID=8YFLogxK
U2 - 10.1002/pd.5206
DO - 10.1002/pd.5206
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AN - SCOPUS:85041647892
SN - 0197-3851
VL - 38
SP - 179
EP - 183
JO - Prenatal Diagnosis
JF - Prenatal Diagnosis
IS - 3
ER -