Department of Obstetrics and Gynecology, KU Leuven, Belgium.
Pediatric Nephrology, KU Leuven, Belgium.
Prenat Diagn. 2017 Dec;37(12):1213-1218. doi: 10.1002/pd.5167. Epub 2017 Nov 21.
To evaluate renal blood flow and renal volume for the prediction of postnatal renal function in fetuses with solitary functioning kidney (SFK).
Seventy-four SFK fetuses (unilateral renal agenesis [12], multicystic dysplastic kidney [36], and severe renal dysplasia [26]) were compared with 58 healthy fetuses. Peak systolic velocity (PSV), pulsatility index (PI), and resistance index (RI) of the renal artery (RA) were measured; 2D and 3D (VOCAL) volumes were calculated. Renal length and glomerular filtration rate (GFR) were obtained in SFK children (2 years).
Compared with the control group, the PSV RA was significantly lower in nonfunctioning kidneys and significantly higher in SFK. Volume measurements indicated a significantly larger volume of SFK compared with healthy kidneys. All but 4 children had GFR above 70 mL/min/1.73 m , and compensatory hypertrophy was present in 69% at 2 years. PSV RA and SFK volume correlated with postnatal renal hypertrophy. No correlation between prenatal and postnatal SFK volume and GFR at 2 years was demonstrated.
Low PSV RA might have a predictive value for diagnosing a nonfunctioning kidney in fetuses with a SFK. We demonstrated a higher PSV RA and larger renal volume in the SFK compared with healthy kidneys.
评估孤立功能肾（SFK）胎儿的肾血流量和肾体积，以预测其出生后的肾功能。
将 74 例 SFK 胎儿（单侧肾发育不全[12]例、多囊性发育不良肾[36]例和严重肾发育不良[26]例）与 58 例健康胎儿进行比较。测量肾动脉（RA）的收缩期峰值速度（PSV）、搏动指数（PI）和阻力指数（RI）；计算二维和三维（VOCAL）体积。在 SFK 儿童（2 岁）中获得肾脏长度和肾小球滤过率（GFR）。
与对照组相比，无功能肾的 RA-PSV 明显较低，SFK 的 RA-PSV 明显较高。体积测量表明，SFK 的体积明显大于健康肾脏。除 4 例儿童外，所有儿童的 GFR 均高于 70 mL/min/1.73 m ，69%的儿童在 2 岁时存在代偿性肥大。RA-PSV 和 SFK 体积与出生后肾肥大相关。在 SFK 体积与 2 岁时的 GFR 之间，未显示出产前与产后之间的相关性。
低 RA-PSV 可能对 SFK 胎儿中诊断无功能肾具有预测价值。与健康肾脏相比，我们在 SFK 中发现了更高的 RA-PSV 和更大的肾脏体积。
