Antenatal and postnatal ultrasound in the evaluation of the risk of vesicoureteral reflux

Grazioli, Serge; Parvex, Paloma; Merlini, Laura; Combescure, Christophe; Girardin, Éric

doi:10.1007/s00467-010-1543-9

Cited by 43 publications

(30 citation statements)

References 32 publications

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“…Renal pelvic dilation (RPD) is the most common organspecific fetal condition detected during the antenatal period and one of the most difficult diagnostic challenges [1][2][3][4][5]. An increasing number of renal anomalies are identified prenatally in otherwise uncomplicated pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Urinary levels of TGF β-1 and of cytokines in patients with prenatally detected nephrouropathies

et al. 2011

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This study aimed to identify noninvasive biomarkers of clinically significant nephrouropathies in patients with antenatal renal and/or urinary tract alterations. Spot-urine levels of interleukin-6 (IL-6), transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α (TNF-α) were measured in 100 patients with antenatal detected nephrouropathies. Patients were divided in idiopathic hydronephrosis (n = 47), urinary tract malformations (n = 35), and dysplastic kidneys (n = 18). Urinary concentrations of TGF-β1, IL-6, and TNF-α were compared between groups according to clinical and image findings. Receiver-operating characteristic (ROC) curves were analyzed for the overall diagnostic accuracy of TGF-β1, IL-6, and TNF-α levels in discriminating infants with nephrouropathies. No significant differences in urinary TGF- β1, IL-6, and TNF-α levels were found in the comparison between the groups. TGF-β1 levels tended to be higher in patients with renal hypodysplasia compared to idiopathic hydronephrosis (p = 0.07). Twenty-nine patients had reduced DMSA uptake. In these cases, absolute urinary concentration of TGF-β1 and levels standardized for creatinine were significantly higher than in patients with normal DMSA uptake, while IL6 and TNF-α did not differ between groups. Urinary cytokine measurements were not useful as a screening test for clinically significant nephrouropathies. Conversely, increased concentrations of TGF-β1 pointed out to renal damage as indicated by reduced DMSA uptake.

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Section: Introductionmentioning

confidence: 99%

Urinary levels of TGF β-1 and of cytokines in patients with prenatally detected nephrouropathies

et al. 2011

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“…Congenital abnormalities of the kidney and urinary tract (CAKUT) is a significant cause of morbidity and mortality in children [1][2][3][4][5][6][7][8]. CAKUT is the most common cause of pediatric end-stage renal disease, accounting for approximately 50% of all cases [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns

et al. 2012

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“…There has been a continuous advance in the understanding of pathophysiology, genetic basis, and natural history of CAKUT (2,(6)(7)(8)(9)(10)(11)(12)(13). However, there are still many controversies regarding the clinical significance of prenatally detected CAKUT.…”

Section: Introductionmentioning

confidence: 99%

Clinical Course of 822 Children with Prenatally Detected Nephrouropathies

Quirino

Diniz

Bouzada

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives With the advent of fetal screening ultrasonography, the detection of congenital anomalies of the kidney and urinary tract (CAKUT) in utero has permitted early management of these conditions. This study aims to describe the clinical course of a large cohort of patients with prenatally detected nephrouropathies.Design, setting, participants, & measurements In this retrospective cohort study, 822 patients were prenatally diagnosed with CAKUT and systematically followed up at a tertiary Renal Unit for a median time of 43 months. Variables included in the analysis were sex, laterality, fetal ultrasonography (isolated versus associated hydronephrosis), and presence/absence of nephrouropathies. The events of interest were urinary tract infection, surgical interventions, hypertension, CKD, and death. Survival analyses were performed to evaluate time until occurrence of the events of interest.Results Urinary tract infection occurred in 245 (29.8%) children, with higher risk in females (hazard ratio=1.30, 95% confidence interval=1.02-1.70, P=0.05); 22 patients (2.7%) had hypertension, and 49 (6%) patients developed CKD. The risk of CKD was greater in patients with associated hydronephrosis (hazard ratio=5.20, 95% confidence interval=2.90-9.30, P,0.001). Twelve patients (1.5%) died during follow-up. Death was significantly associated with being born during the first period of the study (hazard ratio=6.00, 95% confidence interval=1.60-22.50, P,0.001), associated hydronephrosis (hazard ratio=9.30, 95% confidence interval=2.90-29.30, P,0.001), and CKD (hazard ratio=170.00, 95% confidence interval=41.00-228.00, P,0.001).Conclusions In our series, the clinical course of prenatally detected CAKUT was heterogeneous, and those infants with associated hydronephrosis at baseline were identified as a high-risk subgroup.

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Antenatal and postnatal ultrasound in the evaluation of the risk of vesicoureteral reflux

Cited by 43 publications

References 32 publications

Urinary levels of TGF β-1 and of cytokines in patients with prenatally detected nephrouropathies

Urinary levels of TGF β-1 and of cytokines in patients with prenatally detected nephrouropathies

Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns

Clinical Course of 822 Children with Prenatally Detected Nephrouropathies

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