[Prenatal diagnosis of hyperechogenic kidneys: A study of 17 cases].
OBJECTIVE
To evaluate the prenatal diagnosis and the prognostic value of ultrasound in case of fetal hyperechogenic kidneys.


METHODS
Seventeen prenatally diagnosed cases of hyperechogenic kidneys were retrospectively reviewed at the University Hospital of Lille from 1997 to 2008. The clinical and ultrasound data were compared to the postnatal follow-up and the long-term prognosis.


RESULTS
The aetiologies are nine recessive polycystic kidney diseases, three dominant, two Bardet-Biedl syndromes and three cases of transient renal hyperechogenicity. No renal ultrasonographic criterion is specific of aetiology. Five pregnancies were terminated. We observed one neonatal death and 11 survivors (median follow-up: 30months) including two infants with hypertension. All oligohydramnios (n=8) were associated with poor prenatal outcomes (terminations of pregnancy, neonatal death or hypertension) compared to the other nine with normal amniotic fluid volume (nine children symptom-free). Kidneys less or equal to +4 S.D. and a normal amniotic fluid volume were associated with a good prognosis (n=7, seven symptom-free).


CONCLUSIONS
The fetal kidneys characteristics on prenatal ultrasound fail to provide an accurate etiological diagnosis. Only congenital defects and family history adjust the aetiology. Amniotic fluid volume and fetal kidney size are the best prenatal predictors of outcome.
Emmanuelli
V
V
Pôle d'obstétrique, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France. virginiemma@free.fr
Lahoche-Manucci
A
A
Holder-Espinasse
M
M
Devisme
L
L
Vaast
P
P
Dieux-Coeslier
A
A
Dehennault
M
M
Petit
S
S
Besson
R
R
Houfflin-Debarge
V
V
D020788:Bardet-Biedl Syndrome / Q000000981:diagnostic imaging / Q000196:embryology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging* / Q000196:embryology*; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000196:embryology*; D016104:Oligohydramnios; D007690:Polycystic Kidney Diseases / Q000000981:diagnostic imaging / Q000196:embryology / Q000235:genetics; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D016216:Ultrasonography, Prenatal