Are ultrasound renal aspects associated with urinary biochemistry in fetuses with lower urinary tract obstruction?

Nassr, Ahmed A.; Koh, Chester J.; Espinoza, Jimmy; Sangi‐Haghpeykar, Haleh; Sharhan, Dina; Welty, Stephen E.; Angelo, Joseph; Roth, David R.; Belfort, Michael A.; Braun, Michael C.; Ruano, Rodrigo

doi:10.1002/pd.4958

Cited by 28 publications

(23 citation statements)

References 19 publications

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“…However, the systematic review examining this could not determine whether fetal urine measurements can provide a clinically accurate prediction of ultimate renal function . Furthermore, a recent study could not correlate the ultrasound appearance of the fetal kidneys and fetal urinary biochemistry …”

Section: Discussionmentioning

confidence: 99%

Fetal megacystis: Institutional experience and outcomes

Taghavi

Sharpe

Stringer

et al. 2017

Aust NZ J Obst Gynaeco

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Section: Discussionmentioning

confidence: 99%

Fetal megacystis: Institutional experience and outcomes

Taghavi

Sharpe

Stringer

et al. 2017

Aust NZ J Obst Gynaeco

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“…4 Fetal urine biochemistry has been assessed for its capacity to predict postnatal renal function in obstructive uropathy but has yielded controversial results. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] One recent meta-analysis concluded that no single analyte investigated to date could provide clinically relevant prognostic values to predict postnatal renal function. 17 This questionable utility of fetal urinalysis could in part be explained by disparity in methods of analysis, heterogeneity of uropathies, and heterogeneity of the criteria used for the evaluation of postnatal renal function.…”

Section: Introductionmentioning

confidence: 99%

Urine biochemistry to predict long‐term outcomes in fetuses with posterior urethral valves

et al. 2018

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“…However, there are conflicting data on the diagnostic ability of biochemical analysis of the fetal urine in predicting fetal renal outcome . Furthermore, ultrasound parameters of the fetal kidney and urinary biochemistry are not correlated and should be taken separately into account when making a risk assessment for fetuses with LUTO …”

Section: Discussionmentioning

confidence: 99%

Prediction model of postnatal renal function in fetuses with lower urinary tract obstruction (LUTO)—Development and internal validation

et al. 2019

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Objective To develop a prediction model of postnatal renal function in fetuses with lower urinary tract obstruction (LUTO) based on fetal ultrasound parameters and amniotic fluid volume. Methods Retrospective nationwide cohort study of fetuses with postnatally confirmed LUTO and known eGFR. Fetuses treated with fetal interventions such as vesico‐amniotic shunting or cystoscopy were excluded. Logistic regression analysis was used to identify prognostic ultrasound variables with respect to renal outcome following multiple imputation of missing data. On the basis of these fetal renal parameters and amniotic fluid volume, a model was developed to predict postnatal renal function in fetuses with LUTO. The main study outcome was an eGFR less than 60 mL/min * 1.73 m2 based on the creatinine nadir during the first year following diagnosis. Model performance was evaluated by receiver operator characteristic (ROC) curve analysis, calibration plots, and bootstrapping. Results Hundred one fetuses with a confirmed diagnosis of LUTO were included, eGFR less than 60 was observed in 40 (39.6%) of them. Variables predicting an eGFR less than 60 mL/min * 1.73m2 included the following sonographic parameters: hyperechogenicity of the renal cortex and abnormal amniotic fluid volume. The model showed fair discrimination, with an area under the ROC curve of 0.70 (95% confidence interval, 0.59‐0.81, 0.66 after bootstrapping) and was overall well‐calibrated. Conclusion This study shows that a prediction model incorporating ultrasound parameters such as cortical appearance and abnormal amniotic fluid volume can fairly discriminate an eGFR above or below 60 mL/min * 1.73m2. This clinical information can be used in identifying fetuses eligible for prenatal interventions and improve counseling of parents.

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Are ultrasound renal aspects associated with urinary biochemistry in fetuses with lower urinary tract obstruction?

Abstract: In LUTO, the ultrasound appearance of the fetal kidneys and urinary biochemistry are not correlated. It may be better to take both ultrasound and biochemistry into account when evaluating fetuses with fetal LUTO. © 2016 John Wiley & Sons, Ltd.

Cited by 28 publications

References 19 publications

Fetal megacystis: Institutional experience and outcomes

Fetal megacystis: Institutional experience and outcomes

Urine biochemistry to predict long‐term outcomes in fetuses with posterior urethral valves

Prediction model of postnatal renal function in fetuses with lower urinary tract obstruction (LUTO)—Development and internal validation

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