Premium
P47The functionality of renal kidneys. Can amniotic markers be used to diagnose renal pathologies?
Author(s) -
Troyano J. M.,
Clavijo M. T.,
Feo C. M.,
Marco Y.,
Laynez E.
Publication year - 2000
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1046/j.1469-0705.2000.00004-1-47.x
Subject(s) - medicine , amniotic fluid , tonicity , urine , osmotic concentration , hydronephrosis , pathological , urology , kidney , urine osmolality , osmole , fetus , andrology , urinary system , endocrinology , pathology , pregnancy , biology , genetics
Background and method Fetal urine was analysed for differences in renal functionality between physiological cases and pathological cases featuring dilatation of the excretory channels (hydronephrosis). Kidney samples were taken by means of aspirative nephrostomy under echographic monitoring, and 4 parameters were assessed in both amniotic fluid and urine, namely osmolarity, [Na + ], [Cl − ], [ nag ] and [β 2 microglobuline]. Results A total of 51 cases ( healthy group ) presented hypotonic urine, medium osmolarity (200 mosm), low levels of Na + (< 100 mEq/ml), Cl − (< 90 mEq/ml), nag (< 2 U/l) and β microglobuline (< 5 ml/l), and a healthy postnatal evolution. In contrast, the remaining 19 cases ( pathological group ) had hypertonic urine, nag and β 2 microglobuline levels over 18 U/l and 26 ml/l, respectively, and evolved towards heavy renal disfunctionality after delivery. In the pathological group the concentration of nag and β 2 microglobuline in the amniotic fluid was significantly larger than in the physiological group, but no differences in amniotic Na + , Cl − and osmolarity were observed between both groups. Conclusion The concentration of liposomial proteins ( nag and β 2 microglobuline) from the amniotic fluid is a sound indicator of heavy proximal tubulopathy. Invasive techniques such as puncturing can thus be avoided to diagnose fetal disfunctionality.