Congenital hydronephrosis: Prenatal diagnosis and epidemiology in Europe

Abstract

Objective: To describe prevalence, prenatal diagnosis and epidemiology of congenital hydronephrosis (CH) in Europe. Material and method: Data from a large European database for surveillance of congenital malformations (EUROCAT). The 20 participating registries are all based on multiple sources of information and include information about livebirths, fetal deaths with gestational age 20 weeks and terminations of pregnancy after prenatal diagnosis of malformations. Included were all cases with CH and born 1995e2004. Results: There were 3648 cases with CH giving an overall prevalence of 11.5 cases per 10,000 births. The large majority of cases were livebirths (3506, 96% of total) and only 17 cases were fetal deaths and 120 were terminations of pregnancy. Almost all livebirths were alive 1 week after birth. Boys accounted for 72% of all cases. A high proportion of the cases (86%) had an isolated renal malformation. There were large regional differences in prevalence of CH ranging from 2 to 29 per 10,000 births. There was little regional variation in the prevalence of postnatally diagnosed cases while there were large regional differences in prevalence of prenatally diagnosed cases. Conclusion: Cases with CH are mainly livebirths, boys and survive the first week after birth. The large difference in prevalence seems to be related to the availability of prenatal screening in the region. The impact of over-diagnosis and potential over-treatment in regions with high prevalence or under-diagnosis with implications for renal function later in life in regions with low prevalence needs further investigation.

Congenital anomalies of the kidney and the urinary tract: A murmansk county birth registry study

“…In addition, some minor anomalies might be revealed later in life even when the level of prenatal diagnosis of CAKUTs is high. For example, 73% of all congenital hydronephrosis cases were diagnosed prior to birth in Europe in 1995-2004(Garne et al, 2009). …”

Anomalías congénitas de los riñones y de las vías urinarias, una revisión de la literatura*

“…Su detección prenatal mediante ultrasonografía realizada por medicina materno fetal es variable por diversas condiciones, oscilando entre menos del 30% a más del 80% en algunas regiones 2 . Su intervención temprana, impacta favorablemente en su evolución, logrando en algunos casos disminuir o eliminar el riesgo de deterioro de la función renal [3][4][5][6] que se puede presentar en edades tempranas [7][8][9] .…”

“…Las alteraciones morfológicas pueden favorecer tempranamente la aparición de infección urinaria. Importante como estrategia de seguimiento, que en Norteamérica y Europa, se llevan registros organizados de detección prenatal de estas alteraciones y su evolución post natal 2 . El objetivo de esta revisión, es identificar cuáles son los posibles factores de riesgo asociados al desarrollo de anomalías congénitas renales y de la vía urinaria reportados en la literatura científica.…”

Development of the kidney medulla

“…1,2 Moreover, congenital obstructive nephropathy, frequently accompanied by hydronephrosis, is a common cause of renal failure in children. 3 In turn, hydronephrosis is frequently associated with effacement of the renal medulla, the inner zone of the kidney.…”