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
✍ Scribed by BEATRICE M. G. TASSIS; LAURA TRESPIDI; AMEDEA S. TIRELLI; LUISA BOCCONI; CINZIA ZOPPINI; UMBERTO NICOLINI
- Publisher
- John Wiley and Sons
- Year
- 1996
- Tongue
- English
- Weight
- 522 KB
- Volume
- 16
- Category
- Article
- ISSN
- 0197-3851
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✦ Synopsis
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"), creatinine, fl-microglobulin, and N-acetyl-/?-D-glucosaminidase (NAG) were measured. Among the 71 fetal urine samples, both 82-microglobulin and NAG correlated inversely with gestational age, Na+, and Ca2+, but not with creatinine concentrations. However, the correlation of urinary fl-microglobulin with gestational age was dependent on the Na' and Ca2' concentrations, whereas urinary NAG correlated significantly with urinary Na' and CaZ+, and also with gestational age. In fetuses with isolated hydronephrosis, only Na', and not Ca2+, was significantly related to both fl-microglobulin and NAG. Only Na' and p-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 Na+, Ca2+, fl-microglobulin, and NAG, without an obvious superiority of any of these parameters.