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Fetal Diagn Ther. 2017;42(1):17-27. doi: 10.1159/000448952. Epub 2016 Sep 8.

Fetal Serum β2-Microglobulin and Postnatal Renal Function in Lower Urinary Tract Obstruction Treated with Vesicoamniotic Shunt.

Author information

1
Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California, Los Angeles, Calif., USA.

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.

KEYWORDS:

Cordocentesis; Fetal blood sampling; Lower urinary tract obstruction; Vesicoamniotic shunt; β2-Microglobulin

PMID:
27603215
DOI:
10.1159/000448952
[Indexed for MEDLINE]

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