title: Fetal serum ss2-microglobulin and cystatin C in the prediction of post-natal renal function in bilateral hypoplasia and hyperechogenic enlarged kidneys.
abstract: OBJECTIVE
  To evaluate fetal serum ss2-microglobulin and cystatin C in the prediction of post-natal renal function in bilateral hypoplasia and hyperechogenic enlarged kidneys. Predicting post-natal renal function is crucial to the prenatal evaluation of fetal nephropathies. Prenatal ultrasound can identify terminal renal failure, but is not sensitive enough to identify infants whose post-natal renal function will be impaired. Fetal serum ss2-microglobulin and cystatin C are potential predictors of post-natal renal function.
  
  
  METHODS
  Fifty-four prenatally diagnosed cases of bilateral nephropathy were retrospectively reviewed. Final diagnosis was established using histological or post-natal findings: renal hypoplasia (n = 7), cystic dysplasia (n = 9), autosomal dominant polycystic kidney disease (ADPKD; n = 8) or autosomal recessive polycystic kidney disease (ARPKD; n = 22) and transient sonographic abnormalities (n = 8). Fetal serum ss2-microglobulin and cystatin C were assayed respectively in 54 and 38 cases. The prognostic value of these markers was assessed in terms of the post-natal outcome.
  
  
  RESULTS
  In bilateral kidney hypoplasia and cystic dysplasia, ss2-microglobulin and cystatin C were significantly (p < 0.0001 and p < 0.02 respectively) higher than in the normal control group. In hyperechogenic fetal kidneys (ARPKD, ADPKD and transient sonographic abnormalities), these markers were not different from controls. However, whereas normal values cannot exclude renal failure, abnormal values predict post-natal renal failure.
  
  
  CONCLUSIONS
  In bilateral renal hypoplasia and dysplasia, fetal serum ss2-microglobulin and cystatin C are good markers for post-natal renal function. However, in bilateral renal hyperechogenic enlargement, abnormal values are associated with poor post-natal renal function, but normal values cannot preclude renal failure.
authors.affiliation: Biochimie, Hôpital R. Debré Paris, France; Maternité, CHU A. Béclère, Paris, France. francoise.muller@apr.ap-hop-paris.fr
authors.forename: Françoise
authors.initials: F
authors.lastname: Muller
authors.forename: Sophie
authors.initials: S
authors.lastname: Dreux
authors.forename: François
authors.initials: F
authors.lastname: Audibert
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Chabaud
authors.forename: Thierry
authors.initials: T
authors.lastname: Rousseau
authors.forename: Dominique
authors.initials: D
authors.lastname: D'Hervé
authors.forename: Yves
authors.initials: Y
authors.lastname: Dumez
authors.forename: Sandrine
authors.initials: S
authors.lastname: Ngo
authors.forename: Marie-Claire
authors.initials: MC
authors.lastname: Gubler
authors.forename: Marc
authors.initials: M
authors.lastname: Dommergues
mesh_terms: D015891:Cystatins / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism*; D005602:France; D006801:Humans; D007231:Infant, Newborn; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis* / Q000196:embryology; D007677:Kidney Function Tests; D008499:Medical Records; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D015891:Cystatins; D001613:beta 2-Microglobulin