Smit, R. (Rixt) (2019) Renal Echogenicity as Predictor of Postnatal Outcomes of Prenatal Renal Injury. thesis, Medicine.
Full text available on request.Abstract
Objective: The aim of this study was to compare the echogenicity of the renal parenchyma in LUTO patients compared to a matched control group as a noninvasive biomarker in the prediction of postnatal kidney injury. Methods: A total of 17 LUTO patients was collected from 3 tertiary Fetal Medicine Units in the Netherlands. Ultrasound images taken at the date of the LUTO diagnosis were present for 13 of the 17 cases. For the statistical analysis, each of these patients were matched with 2 control group cases, with the gestational age (GA) corresponding to the GA at diagnosis (total n = 39). Longitudinal and transverse views of the kidneys were used to obtain echogenicity ratios of the kidneys and bones. In LUTO patients, the resulting echogenicity ratios were connected to postnatal creatinine nadir values, to estimate the accuracy of the renal echogenicity (RE) in the prediction of postnatal renal insufficiency. Results: Out of the 13 included LUTO patients, “good” renal function (CKD stage 1-2) was found in 7 (54%) of the cases and “poor” renal function (CKD stage 3-5) in the remaining 6 (46%). The mean echogenicity ratio produced by the LUTO group was significantly different from the one produced by the control group (P = 0,017). The ROC analysis of the RE ratio as predictor of renal scarring and possible future renal insufficiency, results in an area under the curve (AUC) with a good discriminative capacity and a c-statistic of 0.941 (CI 95% 0.865-1.000, P < 0.001). For the cut-off value: Z-score = 2,6729, we found sensitivity, specificity and PPV of respectively, 100%, 88,5% and 81,3%. No significant difference was found for the mean echogenicity ratio, when comparing of the “poor” and “good” renal function groups (P = 0,230). This finding was confirmed by the ROC curve analysis (AUC 0,500 CI 95% , 0.168-0.832, p = 1.000). Conclusion: We found insignificant evidence for the prediction of the degree of postnatal renal impairment based on renal echogenicity. A cut-off value was provided as risk indicator for developing renal function impairments in LUTO patients.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Duin, Dr. L.K. and Fontanella, Dr. F. and Obstetrie en Gynaecologie, UMC Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:53 |
| Last Modified: | 25 Jun 2020 10:53 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1365 |
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