Mild renal pyelectasis in the second trimester: determination of cut‐off levels for postnatal referral

Cohen–Overbeek, Titia E.; Wijngaard-Boom, P.; Ursem, Nicolette; Hop, Wim C. J.; Wladimiroff, J. W.; Wolffenbuttel, Katja P.

doi:10.1002/uog.1840

Cited by 28 publications

(18 citation statements)

References 35 publications

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“…On the other hand, it was considerably different from the results of studies detecting the abnormality retrospectively [14][15][16][17]. Those studies seemed to underestimate the incidence.…”

Section: Discussionmentioning

confidence: 47%

Diagnostic accuracy of postnatal ultrasound screening for urinary tract abnormalities

et al. 2010

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The study was aimed at (1) the determination of the incidence of abnormalities of the urinary tract in newborn infants detected by postnatal ultrasound screening, and (2) the evaluation of the diagnostic accuracy of postnatal ultrasound screening for detecting surgical urinary tract abnormalities. The prospective study was of full-term neonates born in the University Hospital of Olomouc in 2005-2008 who underwent renal ultrasound screening after 72 h of life. Significant findings were recorded. Subsequent diagnostic and therapeutic procedures were recorded and evaluated in a group of children with detected renal pelvic dilatation (RPD). (1) A total of 6,088 newborn infants was examined. The absolute and relative RPD incidence rates (anteroposterior diameter, APD) were as follows: 5-7 mm, 146 (2.4%); 7-10 mm, 70 (1.15%); 10-15 mm, 13 (0.21%), and 15 mm or more, 5 (0.08%). Of those, 16 children were operated on for abnormalities of the urinary tract, of which nine (56%) had been detected by prenatal screening. Other findings: six cases of unilateral renal agenesis, four cases of multicystic renal dysplasia, four of renal dystopia, one of polycystic kidney disease and one of renal hypoplasia. (2) A group of 224 children with postnatally detected RPD was examined, of whom 40 (17.9%) underwent voiding cystourethrography and/or scintigraphy and 16 (7.1%) were treated surgically. The receiver operating characteristic curves were analyzed, and the areas under the curves were calculated. Postnatal renal ultrasound screening is probably a suitable test for detecting significant urinary tract abnormalities.

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Section: Discussionmentioning

confidence: 47%

Diagnostic accuracy of postnatal ultrasound screening for urinary tract abnormalities

et al. 2010

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“…In particular, the management of those found to have isolated antenatal hydronephrosis is still a source of controversy. The criteria used in various studies to classify significant antenatal hydronephrosis are often different [4][5][6][7][8][9][10][11][12][13][14][15], and there is a lack of conformity in terms of postnatal management, with some centres advocating detailed investigations, including a micturating cystourethrogram (MCUG) in all groups [6,11,[16][17][18][19], and others adopting a less intensive approach [4,5,13]. The clinician is faced with the dilemma of either subjecting a large number of normal infants to investigations that are significantly invasive [20][21][22][23][24] or arranging fewer investigations and running the risk of missing significant pathology.…”

Section: Introductionmentioning

confidence: 99%

Antenatally detected urinary tract abnormalities: more detection but less action

2008

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We present the findings of a prospective cohort study of babies born with antenatally detected urinary tract abnormalities (AUTAs) between 1999-2003 and compare the outcomes with those of an earlier cohort born between 1989 and 1993. All infants with a fetal anteroposterior renal pelvic diameter (APRPD) > or =7 mm in the third trimester or other urinary tract abnormality underwent a detailed postnatal ultrasound scan and other investigations as indicated. The incidence of AUTAs was significantly greater in the more recent cohort (7.6/1000 vs. 3/1000 live births; p<0.05). Of the 350 infants on which we had data, 48.6% (170/350) were in the non-specific dilatation (NSD) category, and vesicoureteric reflux (VUR) was detected in 12%. Restricting investigations to those who had an APRPD > or =10 mm at >30 weeks of gestation could have reduced the number with NSD in the more recent cohort (26/115; 25%), but 25% of those with pelviureteric junction hold-up and 50% with VUR would have been missed. Significantly fewer patients in the more recent cohort underwent surgery (7 vs. 21%; p<0.001). There is a trend towards larger APRPDs on third trimester scans being associated with more significant pathology, but there is a lot of clinical overlap. The study highlights the need for cautious antenatal counselling combined with an assurance to prospective parents that postnatal investigations will be performed in a stepwise manner based on the initial postnatal ultrasound scan and clinical findings.

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“…Investigations showed total calcium 4.3 mg/dl with ionized calcium 0.68 mmol/L, phosphate 7.7 mg/dl, HCO 3 18 mEq/L, and serum creatinine 10.5 mg/dl, suggesting end-stage renal failure. Correction of hypocalcemia ameliorated the seizure disorder.…”

Section: Patientmentioning

confidence: 99%

“…C ongenital anomalies of the kidney and urinary tract (CAKUT), including vesicoureteral reflux (VUR [MIM 193000]), are major causes of renal failure in childhood (1)(2)(3)(4). Although CAKUT accounts for approximately 0.5% of all pregnancies, the true incidence of CAKUT probably is much higher (3)(4)(5)(6)(7).…”

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confidence: 99%

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A Locus for Renal Malformations Including Vesico-Ureteric Reflux on Chromosome 13q33–34

Vats¹,

Ishwad²,

Singla³

et al. 2006

Journal of the American Society of Nephrology

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Congenital anomalies of kidney and urinary tract (CAKUT), including vesico-ureteric reflux (VUR), are major causes of ESRD in childhood. Herein is reported evidence for a locus on 13q33q34 associated with CAKUT. Deletion mapping of chromosome 13q was performed in four children with CAKUT using 31 microsatellite markers on peripheral blood genomic DNA that was obtained from the patients and their parents. mRNA expression of the positional candidate genes was compared with sequences in electronic databases in silico and also studied in adult and fetal mouse kidneys using reverse transcription-PCR. The children (three girls; age range 5 to 17 yr) had varying severity of developmental delay and other organ system involvement. The spectrum of CAKUT included high-grade VUR (n ‫؍‬ 2), renal dysplasia (n ‫؍‬ 2), and hydronephrosis (n ‫؍‬ 1). Both the children with VUR had evidence of renal failure with one of them developing ESRD. Deletion mapping identified a 7-Mb critical region flanked by markers D13S1311 and D13S285. There are 33 genes (12 known; 21 computer predicted) in this region. In silico expression studies showed matches for 14 of these genes in the kidneys and 10 in the bladder expressed sequenced tags databases. Mouse kidney studies showed that of the 24 genes examined, several had variable expression through the different stages of renal development, whereas five of the genes were not expressed at all. Herein is reported a new locus on chromosome 13q33q34 that can be associated with VUR with several genes showing mRNA expression patterns that suggest their potential for involvement in renal/urinary tract developmental anomalies.

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Mild renal pyelectasis in the second trimester: determination of cut‐off levels for postnatal referral

Abstract: ABSTRACT

Cited by 28 publications

References 35 publications

Diagnostic accuracy of postnatal ultrasound screening for urinary tract abnormalities

Diagnostic accuracy of postnatal ultrasound screening for urinary tract abnormalities

Antenatally detected urinary tract abnormalities: more detection but less action

A Locus for Renal Malformations Including Vesico-Ureteric Reflux on Chromosome 13q33–34

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