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Can we predict the postnatal kidney function prenatally ?


MT / médecine de la reproduction, gynécologie et endocrinologie. Volume 12, Number 2, 95-9, avril-mai-juin 2010, Congrès de médecine fœtale 2010, Morzine

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Author(s) : Françoise Muller, Sophie Dreux, Claire Nguyen, Isabelle Czerkiewicz

Summary : Prenatal diagnosis of uro- and nephropathies includes evaluation of fetal renal function and screening for associated anomalies, based on ultrasound scan and fetal biochemistry (urinalysis and/or fetal blood analysis). In bilateral nephropathies, sensitivity of β2-microglobulin (cut-off: 5 mg/L) for the prediction of renal function is 100% with a 100% specificity in renal agenesis, dysplasia, and hypoplasia. In polycystic kidney diseases, only an abnormal value allowed to predict renal failure (40% sensitivity). Fetal blood β2-microglobulin is correlated with postnatal serum creatinine. In uropathies, a bad biochemical urinalysis score is observed in 84,3% of cases with poor renal function whereas a good score is observed in 82,5% of cases with good postnatal renal function (at 2 years of age). Fetal blood β2-microglobulin presented a 92,7% sensitivity and a 98,4% specificity in the prediction of good postnatal renal function. These biochemical results are better than ultrasound criteria.

Keywords : β2-microglobulin, uropathies, nephropathie, prenatal diagnosis, fetal urine, fetal blood

 

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