Fetal pyelectasis as predictor of decreased differential renal function

Dae Yun Kim, Jennie J. Mickelson, Brian T. Helfand, Max Maizels, William E Kaplan, Elizabeth B Yerkes*

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: A decreased percent of differential function is a common indication for infant pyeloplasty but there is no recognized fetal ultrasound parameter to predict this deficit. We determined whether there is a correlation between fetal pyelectasis and the newborn percent differential function that may enhance prenatal counseling and guide postnatal evaluation. Materials and Methods: Our database was queried for fetal and newborn measures with fetal pyelectasis on ultrasound and the percent of differential function on renal scintigraphy. Fetal pyelectasis data were stratified by estimated gestational age and the percent of differential function. The affected cohort was defined as having 35% or less differential function and the unaffected cohort was defined as having greater than 35%. The Wilcoxon 2-sample test was used for statistical analysis with logistic regression to generate estimated probability models of a decreased percent of differential function vs mm fetal pyelectasis. Results: A total of 831 cases had fetal and newborn ultrasound data available with a total of 229 renal scans identified. Of the 229 cases 36 (16%) had 35% or less differential function on scintigraphy. At estimated gestational age 33 weeks or less the affected cohort had 8 mm greater pyelectasis than the unaffected cohort (OR 1.2, p <0.0001). At estimated gestational age greater than 33 weeks the affected cohort had 4 mm greater pyelectasis than the unaffected cohort (OR 1.07, p <0.07). Subgroup analysis before 33 weeks of estimated gestational age showed similar significance (OR >1, p ≤0.001). Conclusions: Approximately 16% of all fetuses with pyelectasis have 35% or less differential function as newborns, including 36% identified by pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks. Fetal pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks and greater than 16 mm at greater than 33 weeks is associated with 35% or less differential function in the newborn.

Original languageEnglish (US)
Pages (from-to)1849-1853
Number of pages5
JournalJournal of Urology
Volume182
Issue number4 SUPPL.
DOIs
StatePublished - Jan 1 2009

Fingerprint

Pyelectasis
Kidney
Gestational Age
Newborn Infant
Radionuclide Imaging
Counseling
Fetus
Logistic Models
Databases

Keywords

  • Fetus, kidney function
  • Infant, newborn
  • Kidney
  • Ultrasonography

ASJC Scopus subject areas

  • Urology

Cite this

Kim, Dae Yun ; Mickelson, Jennie J. ; Helfand, Brian T. ; Maizels, Max ; Kaplan, William E ; Yerkes, Elizabeth B. / Fetal pyelectasis as predictor of decreased differential renal function. In: Journal of Urology. 2009 ; Vol. 182, No. 4 SUPPL. pp. 1849-1853.
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title = "Fetal pyelectasis as predictor of decreased differential renal function",
abstract = "Purpose: A decreased percent of differential function is a common indication for infant pyeloplasty but there is no recognized fetal ultrasound parameter to predict this deficit. We determined whether there is a correlation between fetal pyelectasis and the newborn percent differential function that may enhance prenatal counseling and guide postnatal evaluation. Materials and Methods: Our database was queried for fetal and newborn measures with fetal pyelectasis on ultrasound and the percent of differential function on renal scintigraphy. Fetal pyelectasis data were stratified by estimated gestational age and the percent of differential function. The affected cohort was defined as having 35{\%} or less differential function and the unaffected cohort was defined as having greater than 35{\%}. The Wilcoxon 2-sample test was used for statistical analysis with logistic regression to generate estimated probability models of a decreased percent of differential function vs mm fetal pyelectasis. Results: A total of 831 cases had fetal and newborn ultrasound data available with a total of 229 renal scans identified. Of the 229 cases 36 (16{\%}) had 35{\%} or less differential function on scintigraphy. At estimated gestational age 33 weeks or less the affected cohort had 8 mm greater pyelectasis than the unaffected cohort (OR 1.2, p <0.0001). At estimated gestational age greater than 33 weeks the affected cohort had 4 mm greater pyelectasis than the unaffected cohort (OR 1.07, p <0.07). Subgroup analysis before 33 weeks of estimated gestational age showed similar significance (OR >1, p ≤0.001). Conclusions: Approximately 16{\%} of all fetuses with pyelectasis have 35{\%} or less differential function as newborns, including 36{\%} identified by pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks. Fetal pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks and greater than 16 mm at greater than 33 weeks is associated with 35{\%} or less differential function in the newborn.",
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Fetal pyelectasis as predictor of decreased differential renal function. / Kim, Dae Yun; Mickelson, Jennie J.; Helfand, Brian T.; Maizels, Max; Kaplan, William E; Yerkes, Elizabeth B.

In: Journal of Urology, Vol. 182, No. 4 SUPPL., 01.01.2009, p. 1849-1853.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Fetal pyelectasis as predictor of decreased differential renal function

AU - Kim, Dae Yun

AU - Mickelson, Jennie J.

AU - Helfand, Brian T.

AU - Maizels, Max

AU - Kaplan, William E

AU - Yerkes, Elizabeth B

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Purpose: A decreased percent of differential function is a common indication for infant pyeloplasty but there is no recognized fetal ultrasound parameter to predict this deficit. We determined whether there is a correlation between fetal pyelectasis and the newborn percent differential function that may enhance prenatal counseling and guide postnatal evaluation. Materials and Methods: Our database was queried for fetal and newborn measures with fetal pyelectasis on ultrasound and the percent of differential function on renal scintigraphy. Fetal pyelectasis data were stratified by estimated gestational age and the percent of differential function. The affected cohort was defined as having 35% or less differential function and the unaffected cohort was defined as having greater than 35%. The Wilcoxon 2-sample test was used for statistical analysis with logistic regression to generate estimated probability models of a decreased percent of differential function vs mm fetal pyelectasis. Results: A total of 831 cases had fetal and newborn ultrasound data available with a total of 229 renal scans identified. Of the 229 cases 36 (16%) had 35% or less differential function on scintigraphy. At estimated gestational age 33 weeks or less the affected cohort had 8 mm greater pyelectasis than the unaffected cohort (OR 1.2, p <0.0001). At estimated gestational age greater than 33 weeks the affected cohort had 4 mm greater pyelectasis than the unaffected cohort (OR 1.07, p <0.07). Subgroup analysis before 33 weeks of estimated gestational age showed similar significance (OR >1, p ≤0.001). Conclusions: Approximately 16% of all fetuses with pyelectasis have 35% or less differential function as newborns, including 36% identified by pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks. Fetal pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks and greater than 16 mm at greater than 33 weeks is associated with 35% or less differential function in the newborn.

AB - Purpose: A decreased percent of differential function is a common indication for infant pyeloplasty but there is no recognized fetal ultrasound parameter to predict this deficit. We determined whether there is a correlation between fetal pyelectasis and the newborn percent differential function that may enhance prenatal counseling and guide postnatal evaluation. Materials and Methods: Our database was queried for fetal and newborn measures with fetal pyelectasis on ultrasound and the percent of differential function on renal scintigraphy. Fetal pyelectasis data were stratified by estimated gestational age and the percent of differential function. The affected cohort was defined as having 35% or less differential function and the unaffected cohort was defined as having greater than 35%. The Wilcoxon 2-sample test was used for statistical analysis with logistic regression to generate estimated probability models of a decreased percent of differential function vs mm fetal pyelectasis. Results: A total of 831 cases had fetal and newborn ultrasound data available with a total of 229 renal scans identified. Of the 229 cases 36 (16%) had 35% or less differential function on scintigraphy. At estimated gestational age 33 weeks or less the affected cohort had 8 mm greater pyelectasis than the unaffected cohort (OR 1.2, p <0.0001). At estimated gestational age greater than 33 weeks the affected cohort had 4 mm greater pyelectasis than the unaffected cohort (OR 1.07, p <0.07). Subgroup analysis before 33 weeks of estimated gestational age showed similar significance (OR >1, p ≤0.001). Conclusions: Approximately 16% of all fetuses with pyelectasis have 35% or less differential function as newborns, including 36% identified by pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks. Fetal pyelectasis greater than 10 mm at estimated gestational age 20 to 24 weeks and greater than 16 mm at greater than 33 weeks is associated with 35% or less differential function in the newborn.

KW - Fetus, kidney function

KW - Infant, newborn

KW - Kidney

KW - Ultrasonography

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