Short-Term Postnatal Renal Function in Twin Anemia-Polycythemia Sequence

Abstract

Objective: To evaluate the short-term renal function in neonates with twin anemia-polycythemia sequence (TAPS). Methods: All consecutive monochorionic twins with TAPS with double survivors admitted to three European centers were included in this retrospective study. Each twin pair was matched for gestational age at birth with a control twin pair unaffected by TAPS or twin-twin transfusion syndrome. Creatinine and urea levels in the first week after birth were recorded. Short-term postnatal renal dysfunction was defined as creatinine >100 μmol/l during the first week after birth. Results: A total of 52 TAPS twin pairs and 52 control twin pairs with a median gestational age of 31 weeks at birth were included in the study. In the TAPS group, donors had higher mean creatinine levels compared to recipients, 85 versus 71 μmol/l, respectively (p = 0.001). Short-term renal dysfunction was detected in 26.0% (13/50) of the donors versus 6.3% (3/48) of the recipients (p = 0.022). In the control group, no inter-twin differences in creatinine levels were found. Conclusions: Donor twins with TAPS have higher creatinine levels than recipient twins, suggesting that chronic inter-twin transfusion in TAPS may also cause short-term renal dysfunction. Long-term renal consequences in TAPS donors require further investigation.

Twin Anemia Polycythemia Sequence: Current Views on Pathogenesis, Diagnostic Criteria, Perinatal Management, and Outcome

“…In addition to lower Hb levels, donor twins with TAPS also have significantly lower albumin and total protein levels compared to recipient twins, suggesting that the inter-twin transfusion process does not only concern red blood cells but also proteins and albumin (Verbeek et al, 2013). Chronic inter-twin transfusion in TAPS may also cause short-term renal dysfunction: Verbeek et al (2015) found that donor twins with TAPS have higher creatinine levels than recipients, probably due to chronic renal hypoperfusion. Whether donor twins may also have permanent renal damage and long-term renal complications is not known.…”

Hyponatremic Hypertensive Syndrome in a Preterm Infant with Twin Anemia–Polycythemia Sequence

“…6 TAPS is considered a form of TTTS, and a recent study showed that the donor of TAPS has higher creatinine levels than the recipient because of chronic intertwin transfusion. 7 In preterm infants, the symptoms of HHS are vague and nonspecific, which makes it difficult to detect the problem. 2 In our case, the patient also showed sepsis-like clinical presentation.…”

Twin Anemia-Polycythemia Sequence (Zwillings-Anämie-Polyzythämie-Sequenz)

“…Anämische Donor-Zwillinge haben neben dem niedrigen Hämoglobinwert auch signifikant erniedrigte Werte an Albumin und Gesamtprotein [24]. Verbeek und Mitarbeiter fanden weiterhin heraus, dass die Nierenfunktion postnatal eingeschränkt sein kann [25]. Ob diese Funktionseinschränkung persistiert, ist noch unklar.…”