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IN FETUSES WITH ISOLATED HYDRONEPHROSIS, URINARY β2‐MICROGLOBULIN AND N ‐ACETYL‐β‐ D ‐GLUCOSAMINIDASE (NAG) HAVE A LIMITED ROLE IN THE PREDICTION OF POSTNATAL RENAL FUNCTION
Author(s) -
TASSIS BEATRICE M. G.,
TRESPIDI LAURA,
TIRELLI AMEDEA S.,
BOCCONI LUISA,
ZOPPINI CINZIA,
NICOLINI UMBERTO
Publication year - 1996
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/(sici)1097-0223(199612)16:12<1087::aid-pd996>3.0.co;2-d
Subject(s) - hydronephrosis , urinary system , beta 2 microglobulin , fetus , renal function , urology , medicine , endocrinology , biology , pregnancy , genetics
Seventy‐one fetal urine samples were taken from the bladder or renal pelvis of 33 fetuses at 13–36 weeks' gestation with a diagnosis of urinary tract anomaly. Severe isolated hydronephrosis in the absence of an enlarged bladder was the indication for sampling in 12/33 fetuses (26 samples), who were retrospectively classified into three groups: normal, intermediate, and dysplastic, based on the evaluation of postnatal renal function or histology. For all samples, urinary sodium (Na + ), calcium (Ca 2+ ), creatinine, β2‐microglobulin, and N‐acetyl‐β‐d‐glucosaminidase (NAG) were measured. Among the 71 fetal urine samples, both β2‐microglobulin and NAG correlated inversely with gestational age, Naand Cabut not with creatinine concentrations. However, the correlation of urinary β2‐microglobulin with gestational age was dependent on the Na + and Ca 2+ concentrations, whereas urinary NAG correlated significantly with urinary Na + and Caand also with gestational age. In fetuses with isolated hydronephrosis, only Naand not Cawas significantly related to both β2‐microglobulin and NAG. Only Na + and β2‐microglobulin were significantly, and similarly, higher in both dysplastic and intermediate kidneys when compared with fetuses with normal postnatal function. If only the last urine sampled was considered, there was overlapping of all parameters in the three groups. In isolated hydronephrosis, only the most extreme forms of renal failure might be suggested by elevated levels of NaCaβ2‐microglobulin, and NAG, without an obvious superiority of any of these parameters.