Tubular and glomerular biomarkers of renal tissue function in the urine of fetuses with posterior urethral valves.

Introduction: Posterior urethral valve (PUV) is a congenital malformation characterized by a membranous structure located in the prostatic portion of the male posterior urethra that obstructs the urinary flow. Efforts have been made to determine the degree of impairment of fetal kidney function in this condition.

Objective: This study aimed to measure the levels of urinary biomarkers of glomerular and tubular functions in fetuses with PUV and to compare with the levels of the same molecules in healthy male premature newborns.

Posterior urethral valve in fetuses: evidence for the role of inflammatory molecules.

Background: The aim of this cross-sectional study was to investigate inflammatory biomarkers in urine samples of 24 fetuses with posterior urethral valve (PUV) collected at 22 ± 4 weeks of gestation and to compare the findings with measurements in urine samples of 22 male healthy preterm neonates at 23 ± 4 weeks (control group).

Methods: Inflammatory biomarkers in urine were measured using a cytometric bead array [interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ, soluable tumor necrosis factor receptor (TNFR) 1, sTNFR2, monocyte chemoattractant protein-1/chemokine ligand 2 (MCP-1/CCL2), eotaxin/CCL11 and interferon gamma-induced protein/10/C-X-C motif chemokine 10 (IP-10/CXCL10)] and ELISA assays [TNF, IL-8/CXCL8 and transforming growth factor-beta (TGF-β)]. The Mann-Whitney test was used to compare medians.

Uromodulin: a new biomarker of fetal renal function?

Introduction: Obstructive uropathies are main diseases affecting the fetus. Early diagnosis allows to establish the appropriate therapy to minimize the risk of damage to kidney function at birth. Biochemical markers have been used to predict the prognosis of renal function in fetuses.

Prediction of lethal pulmonary hypoplasia by means fetal lung volume in skeletal dysplasias: a three-dimensional ultrasound assessment.

Objective: The aim of this study was to assess the capacity of three-dimensional ultrasound (3DUS) for predicting lethality in fetuses with skeletal dysplasia.

Methods: Twenty-four fetuses between 20 and 32 weeks of gestation were assessed. Bilateral lung volume scans were performed three times in each fetus during one ultrasound session.

A predictive model of chronic kidney disease in patients with congenital anomalies of the kidney and urinary tract.

Background: The antenatal detection of congenital anomalies of the kidney and urinary tract (CAKUT) has permitted early management of these conditions. The aim of this study was to identify predictive factors associated with chronic kidney disease (CKD) in CAKUT. We also propose a risk score of CKD.

Prediction of lethal pulmonary hypoplasia among high-risk fetuses via 2D and 3D ultrasonography.

Objective: To compare accuracy between 3D and 2D ultrasonography for predicting lethal pulmonary hypoplasia (LPH) among high-risk fetuses.

Methods: In a cross-sectional prospective study at a fetal medicine referral center in Brazil, bilateral fetal lung scans were evaluated for 54 fetuses with suspected LPH between May 2008 and June 2011. Measurements for predicting LPH were ultrasonographic fetal lung volume/estimated fetal weight ratio (US-FLW), observed/expected thoracic circumference (o/e-TC), observed/expected thoracic circumference/abdominal circumference (o/e-TC/AC), observed/expected thoracic area/heart area (o/e-TA/HA), observed/expected amniotic fluid index (o/e-AFI), and observed/expected total fetal lung volume (o/e-Tot-FLV).

Diagnostic accuracy of renal pelvic dilatation for detecting surgically managed ureteropelvic junction obstruction.

Purpose: In this study we evaluate the diagnostic accuracy of renal pelvic dilatation for detecting infants with prenatal hydronephrosis who will need surgical intervention for ureteropelvic junction obstruction during followup.

Materials And Methods: Between 1999 and 2010, 371 newborns diagnosed with isolated prenatal hydronephrosis were prospectively followed. The main event of interest was the need for pyeloplasty.

Prenatal diagnosis of congenital syngnathia by 3D ultrasound and pathological correlation.

Congenital syngnathia is a maxillomandibular fusion, and it can vary in severity from single mucosal bands (synechiae) to complete bony fusion (synostosis). Cases of combinations of bony or soft tissue adhesions between the mandible and maxilla with cleft of the lip or palate, aglossia, popliteal pterygium, and van der Woude syndrome have been reported. It is a very rare condition, with only one case report of prenatal diagnosis using two-dimensional ultrasound in the literature.

Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns.

Background: Congenital abnormalities of the kidney and urinary tract (CAKUT) are significant causes of morbidity. The aim of the study was to determine predictive factors of mortality in newborns with CAKUT.

Methods: All 29,653 consecutive newborns hospitalized in a tertiary neonatal unit between 1996 and 2006 were evaluated.

Clinical course of 822 children with prenatally detected nephrouropathies.

Background And Objectives: With the advent of fetal screening ultrasonography, the detection of congenital anomalies of the kidney and urinary tract (CAKUT) in utero has permitted early management of these conditions. This study aims to describe the clinical course of a large cohort of patients with prenatally detected nephrouropathies.

Design, Setting, Participants, & Measurements: In this retrospective cohort study, 822 patients were prenatally diagnosed with CAKUT and systematically followed up at a tertiary Renal Unit for a median time of 43 months.

Predictive factors of perinatal mortality in transfused fetuses due to maternal alloimmunization: what really matters?

Introduction: Alloimmunization is the main cause of fetal anemia. There are not many consistent analyses associating antenatal parameters to perinatal mortality in transfused fetuses due to maternal alloimmunization. The study aimed to determine the prognostic variables related to perinatal death.

Antenatal ultrasonographic anteroposterior renal pelvis diameter measurement: is it a reliable way of defining fetal hydronephrosis?

Purpose. It was to quantify the intraobserver and interobserver variability of the sonographic measurements of renal pelvis and classify hydronephrosis severity. Methods.

Ophthalmic artery-resistive index and evidence of overperfusion-related encephalopathy in severe preeclampsia.

Neurological findings in preeclampsia fulfill diagnostic criteria of posterior reversible encephalopathy syndrome (PRES), which is related to cerebral autoregulation impairment associated with high blood pressure. In preeclampsia, PRES may occur without a significant increase in blood pressure. Our aim was to investigate the association between ophthalmic artery resistive index (OARI) and clinical evidence of PRES, defined as the presence of headache and blurred vision, in patients with severe preeclampsia.

Predictive factors for vesicoureteral reflux and prenatally diagnosed renal pelvic dilatation.

Purpose: We sought to identify predictive factors for primary vesicoureteral reflux among infants with prenatally detected renal pelvic dilatation.

Materials And Methods: A total of 250 neonates were diagnosed with isolated renal pelvic dilatation between 1999 and 2008, and followed prospectively. The main event of interest was presence of moderate to severe reflux (grade III to V).

[Isolation, differentiation and biochemical aspects of amniotic fluid stem cell].

Unlabelled: The mesenchymals stem cells (MSCs) are cells with the great potential of differentiation are being introduced in the clinic for treatment of several diseases. Mesenchymal stem cells have several advantages including the stability of their phenotype in vitro.

Background: isolation of MSCs in amniotic fluid, its expansion and the demonstration of the capacity of these cells to differentiate in adipogenic and myogenic cells, without to change the chromosomal stability of the MSCs in culture.

[Correlation between echographic cardiac measurements and hemoglobin deficit in fetus of red cell alloimmunized pregnancies].

Purpose: to verify the correlation between ultrasonography heart measures and hemoglobin deficit in fetuses of alloimmunized pregnant women.

Methods: a transversal study, including 60 fetuses, with 21 to 35 weeks of gestational age, from 56 isoimmunized pregnant women. A number of 139 procedures were performed.

Risk factors for urinary tract infection in children with prenatal renal pelvic dilatation.

Purpose: The aim of this study was to identify risk factors for urinary tract infection during followup of children with fetal renal pelvic dilatation.

Material And Methods: A total of 192 patients were diagnosed with isolated renal pelvic dilatation between 1999 and 2006 and were prospectively followed. After initial clinical and imaging evaluation ultrasound, clinical examination and laboratory reviews were scheduled at 6-month intervals.

Outcome of isolated antenatal hydronephrosis: a prospective cohort study.

The purpose of this study was to report the outcome of infants with antenatal hydronephrosis. Between May 1999 and June 2006, all patients diagnosed with isolated fetal renal pelvic dilatation (RPD) were prospectively followed. The events of interest were: presence of uropathy, need for surgical intervention, RPD resolution, urinary tract infection (UTI), and hypertension.

[Assessment of the correlation between hemoglobin concentration and the echographic measurement of biventricular outer diameter in anemic fetuses of isoimmunized women].

Objective: To assess whether a significant correlation exists between the echographic measurement of biventricular outer diameter and the pretransfusional serum concentration of fetal hemoglobin and whether that echographic measurement can be used as a noninvasive marker of fetal anemia.

Methods: A prospective cross-sectional study was carried out comprising 65 cordocenteses performed in 36 anemic fetuses of mothers with isoimmunization to the Rh antigen. The biventricular outer diameter (BOD) was obtained by M-mode evaluation.

Diagnostic accuracy of postnatal renal pelvic diameter as a predictor of uropathy: a prospective study.

Background: There is a necessity to standardize postnatal ultrasonographic markers predictive of significant uropathies. The purpose of this study was to assess the accuracy of anteroposterior renal pelvic diameter (APD) on postnatal ultrasound to discriminate between significant uropathy and idiopathic renal pelvic dilatation.

Materials And Methods: Neonates ( n=110) who were found to have isolated fetal renal pelvic dilatation underwent systematic investigation and were prospectively followed up.

Outcome of apparent ureteropelvic junction obstruction identified by investigation of fetal hydronephrosis.

Objectives: The purpose of the study was to evaluate the outcome of prenatally detected ureteropelvic junction obstruction (UPJO) managed with a more conservative protocol.

Methods: The records and imaging studies of 77 consecutive neonates with UPJO identified by fetal hydronephrosis were reviewed. A nonoperative approach was attempted in patients with mild/moderate pelvic dilatation, renal units with good function as ascertained by DMSA scan and a non-obstructed pattern on DTPA.

Prognostic factors in prenatally-detected posterior urethral valves: a multivariate analysis.

To identify prognostic factors associated with chronic renal insufficiency in children with posterior urethral valves (PUV), 22 children with PUV were submitted to a systematic protocol and prospectively followed. Prognostic factors associated with fetal echography and clinical and laboratory findings were studied on admission. Median follow-up was 76 months.

Spontaneous improvement of hypertension in multicystic dysplastic kidney: a case report.

We report a case of transitory hypertension associated with unilateral multicystic dysplastic kidney (MCDK). A newborn girl with MCDK, detected by prenatal ultrasonography, was conservatively treated and has been followed for 18 months at the Pediatric Nephrourology Unit (HC-Belo Horizonte, Brazil). Arterial hypertension was observed at about 4 months of age and was associated with high levels of plasma renin activity and circulating angiotensin, and also with changes in renal Doppler ultrasonography.