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01-04-2016 | Educational Review

Severe antenatally diagnosed renal disorders: background, prognosis and practical approach

Authors: Wiebke Aulbert, Markus J. Kemper

Published in: Pediatric Nephrology | Issue 4/2016

Abstract

Nowadays most renal disorders, especially urinary tract malformations and renal cystic disease, are diagnosed antenatally. In cases of severe bilateral disease, intrauterine renal dysfunction may lead to renal oligohydramnios (ROH), resulting in pulmonary hypoplasia which affects perinatal mortality and morbidity as well as the long-term outcome. However, some infants may only have mild pulmonary and renal disease, and advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcome even in those infants with severe ROH. Here, we review the current state of knowledge and clinical experience of patients presenting antenatally with severe bilateral renal disorders and ROH. By addressing underlying mechanisms, intrauterine tools of diagnosis and treatment as well as published outcome data, we hope to improve antenatal counselling and postnatal care.

Key summary points

Nowadays most renal disorders are diagnosed antenatally, especially urinary tract malformations and renal cystic disease.

Severe kidney dysfunction may lead to renal oligohydramnios, which can cause pulmonary hypoplasia and is a risk factor of perinatal mortality and postnatal renal outcome. However, as considerable clinical heterogeneity is present, outcome predictions need to be treated with caution.

Advances in postnatal and dialysis treatment have resulted in improved short- and long-term outcomes even in infants with severe renal oligohydramnios.

A multidisciplinary approach with specialist input is required when counselling a family with an ROH-affected fetus as the decision-making process is very challenging.

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Title: Severe antenatally diagnosed renal disorders: background, prognosis and practical approach
Authors: Wiebke Aulbert
Markus J. Kemper
Publication date: 01-04-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 4/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-015-3140-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Severe antenatally diagnosed renal disorders: background, prognosis and practical approach

Abstract

Key summary points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Key summary points

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