1. Fetal Serum β2-Microglobulin and Postnatal Renal Function in Lower Urinary Tract Obstruction Treated with Vesicoamniotic Shunt.
- Author
-
Chon AH, de Oliveira GH, Lemley KV, Korst LM, Assaf RD, and Chmait RH
- Subjects
- Adult, Amnion embryology, Biomarkers blood, Cohort Studies, Cordocentesis, Female, Fetal Blood metabolism, Follow-Up Studies, Humans, Infant, Newborn, Male, Postoperative Complications epidemiology, Postoperative Complications etiology, Postoperative Complications physiopathology, Postoperative Complications prevention & control, Pregnancy, Renal Insufficiency, Chronic epidemiology, Renal Insufficiency, Chronic physiopathology, Renal Insufficiency, Chronic prevention & control, Retrospective Studies, Risk, Urethra abnormalities, Urinary Bladder abnormalities, Urinary Bladder embryology, Urogenital Abnormalities blood, Urogenital Abnormalities embryology, Urogenital Abnormalities physiopathology, Amnion surgery, Kidney physiopathology, Renal Insufficiency, Chronic etiology, Urinary Bladder surgery, Urinary Diversion adverse effects, Urogenital Abnormalities surgery, beta 2-Microglobulin blood
- Abstract
Introduction: Although mortality has decreased for fetuses with lower urinary tract obstruction treated with vesicoamniotic shunt (VAS) placement, survivors remain at risk for long-term renal impairment. We tested the association of fetal serum β2-microglobulin (fsβ2M) with postnatal renal function in these patients, hypothesizing that fsβ2M may predict such renal impairment., Materials and Methods: fsβ2M was obtained in patients undergoing VAS placement. The primary outcome was renal function at 3-12 months of life, as assessed by a pediatric nephrologist using medical records. Patients were divided into two groups: (1) 'stable renal function' - probable stable long-term renal function and reasonable growth - and (2) 'loss of renal function' - early loss of renal function and failure to thrive., Results: Nineteen patients with preoperative fsβ2M received a VAS. Of the 14 survivors, those with fsβ2M ≤5.6 mg/l tended to have stable renal function compared to those with fsβ2M >5.6 mg/l [5/6 (83.3%) vs. 2/8 (25.0%), OR = 15.00, 95% CI 0.70-709.89; p = 0.1026]. Eight of 9 patients followed for >12 months of age had outcomes consistent with the initial renal assessments., Discussion: Patients with initial fsβ2M >5.6 mg/l and treated with VAS tended to have poor renal outcomes., (© 2016 S. Karger AG, Basel.)
- Published
- 2017
- Full Text
- View/download PDF