Prä- und postnatales Nierenscreening im Vergleich: eine Analyse von 34.450 Neugeborenen des Geburtenregisters Mainzer Modell

Stolz, Gabriela; Schumacher, R. A.; Wiesel, Awi; Schlaefer, Klaus; Queißer‐Luft, Annette

doi:10.1007/s00117-002-0773-7

Cited by 13 publications

(6 citation statements)

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“…The overall intervention rate in our study was 21.8%, which is in agreement with the literature, where intervention rates range from 7 and 28% [2,3,18,34]. The proportion of children who needed an intervention immediately after birth or during follow-up in our study was highest in those with the most severe forms of hydronephrosis, which is in agreement with the literature [2,6,19].…”

Section: Discussionsupporting

confidence: 91%

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Diagnostic accuracy of an interdisciplinary tertiary center evaluation in children referred for suspected congenital anomalies of the kidney and urinary tract on fetal ultrasound - a retrospective outcome analysis

et al. 2021

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Background Fetal ultrasound organ screening has become a standard of care in most high-income countries. This has resulted in increased detection of congenital abnormalities, which may lead to major uncertainty and anxiety in expectant parents, even though many of them are of minor relevance. In order to optimize prenatal counselling, we introduced an interdisciplinary approach for all pregnant women referred to our center by private obstetricians for a co-assessment of suspected relevant fetal abnormalities of the kidney or urinary tract, involving both experienced prenatal ultrasound specialists and a pediatric nephrologist or urologist. Methods In a retrospective analysis, we evaluated reports of intrauterine evaluation and postnatal follow-up in order to assess accuracy of explicit intrauterine diagnoses and outcome of hydronephroses according to their severity in this setting. Results A total of 175 fetuses were examined between 2012 and 2019 and followed postnatally at our Pediatric Nephrology or Urology Department. There was a high concordance (85.9%) between explicit intrauterine and final diagnoses. Resolution rate of hydronephrosis was higher in patients with intrauterine low-grade than high-grade hydronephrosis (61.8% versus 11.9%). An etiological diagnosis was found in 62.5%, 52.0%, and 11.1% of patients with intrauterine bilateral high-grade, unilateral high-grade, and unilateral high-grade with contralateral low-grade hydronephrosis, respectively, but in none of the patients with intrauterine low-grade hydronephrosis. Conclusions The results of our study demonstrate that, through interdisciplinary teamwork, intrauterine assessment of the fetal kidneys and urinary tract is highly accurate and allows a good discrimination between relevant and transient/physiological hydronephroses. Graphical abstract

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Section: Discussionsupporting

confidence: 91%

“…The sensitivity of intrauterine diagnosis for kidney and urinary tract anomalies ranges between 35.7 and 88.5% in the literature [17,[32][33][34], but could not be calculated in our study due to the unknown number of false-negative cases.…”

Section: Discussionmentioning

confidence: 80%

Diagnostic accuracy of an interdisciplinary tertiary center evaluation in children referred for suspected congenital anomalies of the kidney and urinary tract on fetal ultrasound - a retrospective outcome analysis

et al. 2021

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“…Today, the use of ultrasonographic imaging has allowed great progress in diagnosing urinary system anomalies. Prenatal US screening of the urinary system proved not to be sensitive enough due to many subjective and objective factors [29,36,37]. Nevertheless, this method successfully diagnosed many cases of hydronephrosis in utero.…”

Section: Discussionmentioning

confidence: 99%

“…Among all CAKUT diagnosed by postnatal US screening, only 15.2% and 39% were found prenatally [29,30,38]. German authors computed the sensitivity of prenatal US screening to be 36%, and the accuracy rate was 99% [37]. This data suggests that every infant could benefit from both a prenatal and postnatal US screening of the urinary tract, as it enables prompt detection of any CAKUT.…”

Section: Discussionmentioning

confidence: 99%

Clinical importance of pyelocalyceal dilation diagnosed by postnatal ultrasonographic screening of the urinary tract

Drnašin¹,

Saraga-Babić

Saraga

2013

Med Sci Monit

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BackgroundUltrasonographic (US) screening of the urinary tract (UT) in infants was used to determine if there is a connection between the frequency of pyelocaliceal dilation (PCD) in asymptomatic infants with normal antenatal US screening and occurrence of congenital anomalies of kidney and urinary tract (CAKUT) and urinary tract infections (UTI).Material/MethodsUS screening of the UT was performed on 1000 healthy infants, 7 days to 6 months old. Two subgroups of kidneys were described: subgroup 1 contained kidneys with anterior posterior pelvic diameter (APPD) of 5–9.9 mm, and subgroup 2 with APPD over 10 mm. US examinations and methods for detection of UTI and CAKUT were used.Results PCD was found in 74 infants (7.4%): 1.9% of infants had CAKUT, and 8.4% had UTI. In subgroup 1, CAKUT was found in 4 (6.3%) and UTI in 9 (14.3%) infants. In subgroup 2, CAKUT was found in 6 (54.5%), and UTI in 4 (36.4%) infants.ConclusionsMild PCD significantly increases the risk for CAKUT but not for UTI. Moderate to severe PCD significantly increases risk for both CAKUT and UTI. The postnatal US screening of UT is recommended for improved detection of PCD and associated CAKUT. Indirectly, postnatal US screening of UT can help in detecting people at risk for UTI in the first year of life, and therefore help prevent possible kidney damage.

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“…Most children with CAKUT are diagnosed prenatally in developed countries, 4 5 largely because of the widespread use of fetal ultrasonography. Recently, postnatal ultrasound screening has been reported to be a useful method in the early detection and intervention of CAKUT, 6–9 as this technique can confirm abnormalities detected in the fetus and it can detect undiscovered abnormalities during the prenatal period, 5 10 which may minimise renal damage and thereby improve quality of life.…”

Section: Introductionmentioning

confidence: 99%

Early detection of congenital anomalies of the kidney and urinary tract: cross-sectional results of a community-based screening and referral study in China

Gong

Zhang²,

Shen

et al. 2018

BMJ Open

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ObjectiveTo establish an effective screening model of congenital anomalies of the kidney and urinary tract (CAKUT) using ultrasound among neonates in Shanghai, China.DesignCross-sectional study.SettingA three-level screening model for CAKUT in neonates based on the child healthcare system was established since 2010 in Minhang District, Shanghai, China.ParticipantsDuring 2010–2015, neonates with criteria such as preterm, low birth weight and so on were eligible to participate in the study. Cases with renal pelvis dilatation (RPD) and other abnormal renal findings were managed based on presumed strategies.Main outcome measuresThe proportion of RPD and other renal and urinary tract anomalies; number of diagnosed CAKUT under integrated management, especially obstructive uropathy. The anterior–posterior renal pelvic diameter (APRPD) cut-off points for likelihood of obstructive uropathy and need for surgery.ResultsA total of 8827 infants were consecutively screened. Absolute and relative rates of different degrees of RPD classified by APRPD were: mild (5–9.9 mm), 984 (11.1%); moderate (10–14.9 mm), 176 (2.0%); severe (≥15 mm), 20 (0.2%). Of 639 followed cases with RPD, 11 were diagnosed as obstructive uropathies. Of these, nine patients underwent surgery, at median age 2 months. A total 85.4% of mild, 62.5% of moderate and 30.0% of severe RPD cases resolved spontaneously. Other renal and urinary morphological abnormalities were diagnosed in 15 (0.2%) patients. The APRPD cut-off points for significant obstructive uropathy and need for surgery were 9.7 mm and 13.5 mm, respectively.ConclusionsThis three-level screening model is an effective and feasible strategy for early detection and intervention of CAKUT in the early postnatal period, especially for patients with high-grade RPD and other renal and urinary malformations. This strategy could be useful in China and other developing areas with limited medical resources.

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Prä- und postnatales Nierenscreening im Vergleich: eine Analyse von 34.450 Neugeborenen des Geburtenregisters Mainzer Modell

Cited by 13 publications

References 13 publications

Diagnostic accuracy of an interdisciplinary tertiary center evaluation in children referred for suspected congenital anomalies of the kidney and urinary tract on fetal ultrasound - a retrospective outcome analysis

Diagnostic accuracy of an interdisciplinary tertiary center evaluation in children referred for suspected congenital anomalies of the kidney and urinary tract on fetal ultrasound - a retrospective outcome analysis

Clinical importance of pyelocalyceal dilation diagnosed by postnatal ultrasonographic screening of the urinary tract

Early detection of congenital anomalies of the kidney and urinary tract: cross-sectional results of a community-based screening and referral study in China

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