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Can we predict the postnatal kidney function prenatally ? Volume 12, issue 2, avril-mai-juin 2010

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Biochimie-hormonologie, Hôpital Robert-Debré, Université, Paris Île-de-France Ouest, France

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.