Ultrasound evaluation for prediction of outcomes and surgical decision in fetal hydronephrosis

Zhang, Dan; Sun, Xielu; Xiao-le, Chen; Yu, Bo; Li, Tianran; Cheng, Yueyue; Ye, Manjing; Lin, Lingling; Ma, Lie; Zhao, Ying‐Zheng; Li, Pihong

doi:10.3892/etm.2019.7683

Cited by 9 publications

(14 citation statements)

References 26 publications

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“…In many cases, mainly LG fetal hydronephrosis has been shown to be transient and to represent a physiological phenomenon [14,19,22]. Transient hydronephrosis has been reported in 47.0-72.0% of patients and in 62.0-87.2% of kidney units in the literature [2,10,14,19], strongly dependent upon the degree of hydronephrosis [2,4,19,22,23]. In our study complete resolution of hydronephrosis occurred in 78.6% of all patients with unilateral LG and 56.1% of all patients with bilateral LG hydronephrosis in group 1.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…In a cohort of 115 fetuses with antenatal hydronephrosis, Nef et al described 38 cases of resolution in the postnatal life (six cases in the first week after birth and another 32 cases of resolution in the follow-up period) [12]. An 87.2% resolution rate was noted by Zhang and coworkers with no cases of new diagnosis of hydronephrosis; lower SFU grades were associated with a more frequent resolution [13]. In 276 neonates, Elmaci and coworkers registered a resolution in 92.7% and 51.1% of cases in mild and severe grades in a mean time of 5 and 11 months, respectively [14].…”

Section: Review Of the Literaturementioning

confidence: 98%

“…Eight articles dealt with the postnatal outcome and resolution of an antenatally detected hydronephrosis [11][12][13][14][15][16][17][18].…”

Section: Review Of the Literaturementioning

confidence: 99%

“…Six authors did not find any case of false postnatal resolution (i.e., an apparent normal US postanal followed by a new diagnosis of hydronephrosis) [11][12][13][14][15][16]. Loardi and coworkers included in their analysis 90 patients with moderate to severe prenatal hydronephrosis; the authors found a 58% rate of postnatal resolution at the first ultrasound evaluation and risk of surgery of 25% and 60% in moderate and severe cases, respectively [11].…”

Section: Review Of the Literaturementioning

confidence: 99%

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Prenatal Diagnosis of Severe Fetal Hydronephrosis Due to Pyeloureteral Junction Syndrome with False Neonatal Resolution

et al. 2021

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A case of severe fetal hydronephrosis due to isolated bilateral stenosis of the pyelo-ureteral junction was diagnosed at our centre. Surprisingly, a negative renal ultrasound scan was performed on the 3rd postnatal day. An ultrasound follow-up showed severe bilateral pyelectasis a few weeks later. The infant underwent bilateral pyeloplasty at six months of age with an excellent outcome. Such a neonatal picture may be due to the reduction of urinary output secondary to excessive postnatal weight loss and dehydration. In this case, prenatal ultrasound result was more reliable than postnatal ultrasound, emphasizing the importance of postnatal urologic follow-up after prenatal indication.

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“…In addition to the unilateral ureteral obstruction model, the up-regulation of SIRT1 in murine renal medullary interstitial cells was reported to repress the COX2 level during oxidative stressinduced to recovery the interstitium from inflammation and fibrogenesis (25). Moreover, the SIRT1 knockout mice was showed to be impairment of angiogenesis, reduction of matrilytic activity, and retention of the profibrotic cleavage substrate tissue transglutaminase as well as endoglin-accompanied MMP-14 suppression (26)(27)(28). Recovery of MMP-14 expression in SIRT1-knock out mice was reported as many phenotypic changes including improving the angiogenic and matrilytic functions of the endothelium, inhibiting renal dysfunction, even attenuating nephrosclerosis (29).…”

Section: Introductionmentioning

confidence: 99%

Exploration the potential mechanism of the SIRT1 and its target gene FOXO1/PPARGC1A in uteropelvic junction obstruction

Zhao¹,

Liu²,

Yin³

et al. 2021

Transl Androl Urol

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Background: Uteropelvic junction obstruction (UPJO) is a common surgical condition, which refers to the blockage of urine flowing through kidney into proximal upper ureter. However, the underlying mechanism of UPJO is poorly understood, especially the regulated and targeted genes of sirtuin 1 in UPJO. Methods:We sequenced three renal tissues on the obstructed side of independent children with <20% differential renal function (DRF) and three samples with >40% DRF. Gene expression values were obtained and compared for differentially expressed genes (DEGs). Protein-protein interaction (PPI) analysis was conducted to identify the overlapping proteins of DEGs and Sirtuin 1 (SIRT1). The co-expression genes of overlapped genes were computed using Pearson correlation coefficient. The potential role of SIRT1 gene in UPJO was explored by resequencing 3 microarray data from RNA interference (RNAi) SIRT1 lines of renal tubular epithelial (NRK52E) cells in rat and three control datasets were sequenced again. The DEGs were obtained as parallel. GO/KEGG enrichment analysis and co-expression network were conducted to explore the underlying mechanism, particularly shared pathways or function in GO/KEGG enrichment analysis results.Results: A total of 427 up-regulated genes and 1,099 down-regulated genes were identified among 3 mRNAseq of renal tissue on the obstructed side of the independent children with <20% DRF and 3 samples with >40% DRF. According to prediction using the Search Tool for Retrieval of Interacting Genes/Proteins, 2 PPIs, FOXO1 and PPARGC1A, were identified among 2,524 DEGs, predicted as targets of SIRT1. Gene set enrichment analysis (GSEA) of their co-expression genes showed they may co-participate in biological activities including fatty acid degradation, regulation of signal transduction by p53 mediator. Moreover, GSEA results of DEGs was confirmed through RNAi SIRT1 lines of rat renal tubular epithelial (NRK52E) cells.Conclusions: UPJO may cause abnormal phenotypic changes of renal tubular epithelial cells through SIRT1/FOXO1 mediated protein transport, establishment of protein localization, and intracellular transport.In addition, UPJO is involved in regulation of signal transduction, regulation of intracellular estrogen receptor signaling pathways, and nucleoprotein localization through SIRT1/PPARGC1A-mediated p53 mediators, causing abnormal phenotypic changes in renal tubular epithelial cells.

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Ultrasound evaluation for prediction of outcomes and surgical decision in fetal hydronephrosis

Cited by 9 publications

References 26 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

Prenatal Diagnosis of Severe Fetal Hydronephrosis Due to Pyeloureteral Junction Syndrome with False Neonatal Resolution

Exploration the potential mechanism of the SIRT1 and its target gene FOXO1/PPARGC1A in uteropelvic junction obstruction

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