Fetal Serum Beta(2)-Microglobulin And Postnatal Renal Function In Lower Urinary Tract Obstruction Treated With Vesicoamniotic Shunt

Introduction: Although mortality has decreased for fetuses with lower urinary tract obstruction treated with vesicoamniotic shunt (VAS) placement, survivors remain at risk for long-term renal impairment, We tested the association of fetal serum beta(2)-microglobulin (fs beta M-2) with postnatal renal function in these patients, hypothesizing that fs beta M-2 may predict such renal impairment. Materials and Methods: fs beta M-2 was obtained in patients undergoing VAS placement, The primary outcome was renal function at 3-12 months of life, as assessed by a pediatric nephrologist using medical records. Patients were divided into two groups: (1) 'stable renal function'-probable stable long-term renal function and reasonable growth - and (2) 'loss of renal function' early loss of renal function and failure to thrive. Results: Nineteen patients with preoperative fs beta M-2 received a VAS, Of the 14 survivors, those with fs 32M s5.6 mg/l tended to have stable renal function compared to those with fs beta M-2 >5,6 mg/l 5/6 (83.3%) vs, 2/8 (25,0%), OR = 15.00, 95% CI 0.70-709.89; p = 0.1026]. Eight of 9 patients followed for >12 months of age had outcomes consistent with the initial renal assessments. Discussion: Patients with initial fs beta M-2 >5,6 mg/l and treated with VAS tended to have poor renal outcomes, (C) 2016 S. Karger AG, Basel