Can quantity of amniotic fluid reliably predict postnatal renal function in boys with posterior urethral valves: a decision curve analysis

Harper, Luke; Waubant, Alice; Vignes, Julien; Amat, Sara; Dobremez, E.; Lefèvre, Yan; Ferdynus, Cyril

doi:10.1002/pd.5120

Cited by 7 publications

(3 citation statements)

References 10 publications

(23 reference statements)

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“…Recently, Fontanella F [ 26 ] found that the bladder volume at diagnosis was the best single predictor of a severely decreased estimated glomerular filtration rate in LUTO fetuses referred before the 26th week of gestation. Moreover, an increased bladder volume was also correlated with oligohydramnios in our cohort, and oligohydramnios was reported to predict postnatal renal impairment with a positive likelihood ratio of 17.0 [ 27 ] Such impairment of renal function can result in cardiac dysfunction via the abovementioned pathways.…”

Section: Discussionmentioning

confidence: 87%

Decreased biventricular myocardial deformation in fetuses with lower urinary tract obstruction

Zhou

et al. 2020

BMC Pregnancy Childbirth

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Background To observe myocardial deformations in fetuses with isolated lower urinary tract obstruction (LUTO) and identify the correlation between myocardial deformation and the severity of obstruction. Methods The strain (S), strain rate in systole (SRs) and strain rate in diastole (SRd) of the left and right ventricles at the first examination were prospectively analyzed and compared between fetuses with isolated LUTO and gestational age (GA)-matched normal control fetuses. Multiple regression analyses were used to assess the obstructive factors for impaired strain and strain rate, and the independent variables included bladder volume, sum of the bilateral pelvic diameters, sum of the bilateral ureteral diameters, mean bilateral renal artery pulsatility index, and amniotic fluid index. Results Thirty-six fetuses with isolated LUTO and 36 normal controls were enrolled. Overall, decreased S, SRs and SRd of both ventricles were noted in fetuses with LUTO ( p < 0.001). Moreover, S and SR were significantly negatively related to distended bladder volume ( p < 0.001). Conclusions Fetuses with LUTO demonstrated decreased left and right myocardial deformation, and this impaired cardiac dysfunction was correlated with the urinary bladder volume. Evaluating the myocardial deformation in fetal LUTO could provide information to aid in parental counselling and intervention monitoring.

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Section: Discussionmentioning

confidence: 87%

Decreased biventricular myocardial deformation in fetuses with lower urinary tract obstruction

Zhou

et al. 2020

BMC Pregnancy Childbirth

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“…Nadir creatinine is considered a predictor of CKD and ESKD in children affected by PUVs who underwent surgical correction, although strong literature about its reliability is still lacking ( 19 , 39 , 40 ).…”

Section: Discussionmentioning

confidence: 99%

Nadir creatinine as a predictor of renal outcomes in PUVs: A systematic review and meta-analysis

et al. 2023

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BackgroundPosterior urethral valves (PUVs) represent the most severe pediatric obstructive uropathy, responsible for chronic renal failure in up to 65% of cases and progression to end-stage kidney disease (ESKD) in about 8%–21% of patients. Unfortunately, renal outcomes have poorly improved over time. The key point is to identify patients at risk; thus, several prenatal and postnatal prognostic factors have been analyzed to improve clinical outcomes. Postnatal nadir creatinine seems to accurately predict long-term renal prognosis, but there is no definitive evidence to support this finding.ObjectiveWe performed a systematic review with meta-analysis to analyze the predictive value of nadir creatinine on long-term renal function in infants with PUVs.MethodsWe conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed and Cochrane Library were systematically searched for studies published from January 2008 to June 2022. All the articles were checked independently by two reviewers in two steps.ResultsA total of 24 articles were screened, and 13 were included for data extraction. Data from 1,731 patients with PUVs were analyzed, with a mean follow-up of 5.5 years; of these, on average, 37.9% developed chronic kidney disease (CKD) and 13.6% developed ESKD. All the articles evaluated nadir creatinine as a predictor of CKD, most using a level of 1 mg/dL, with statistical significance at the 5% level. The relative risk of developing CKD in patients with creatinine values higher than the nadir cutoff considered was 7.69 (95% CI: 2.35–25.17, I2 = 92.20%, p < 0.001).ConclusionsNadir creatinine is the best prognostic factor for long-term renal function in patients affected by PUV. A value above the cutoff of 1 mg/dL should be considered a significant predictor for the risk of CKD and ESKD. Further studies are needed to define different nadir creatinine cutoffs for better stratification of the different CKD stages and for the development of reliable scores, which include the association of several variables.

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“…Progressive oligohydramnios and anhydramnios are associated with a high risk of severe lung dysplasia and death. Furthermore, a poor echogenity of the renal cortex and a poor bladder filling during the ultrasonography are signs of poor prognosis and are associated with renal failure in newborns [5]. According to Sarhan et al 2017, the birth weight does not influence the prognosis regarding kidney function in patients with PUV.…”

Section: Antenatal Diagnosis and Prognostic Factorsmentioning

confidence: 99%

Prognostic Biomarkers and Factors in Posterior Urethral Valves

Luchița¹,

Serban²,

Ionescu³

2020

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Can quantity of amniotic fluid reliably predict postnatal renal function in boys with posterior urethral valves: a decision curve analysis

Abstract: In this retrospective study, DCA confirms the relationship between prenatal quantity of amniotic fluid volume and postnatal renal function. © 2017 John Wiley & Sons, Ltd.

Cited by 7 publications

References 10 publications

Decreased biventricular myocardial deformation in fetuses with lower urinary tract obstruction

Decreased biventricular myocardial deformation in fetuses with lower urinary tract obstruction

Nadir creatinine as a predictor of renal outcomes in PUVs: A systematic review and meta-analysis

Prognostic Biomarkers and Factors in Posterior Urethral Valves

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