Analysis of renal blood flow and renal volume in normal fetuses and in fetuses with a solitary functioning kidney

Prenat Diagn. 2017 Dec;37(12):1213-1218. doi: 10.1002/pd.5167. Epub 2017 Nov 21.

Abstract

Objective: To evaluate renal blood flow and renal volume for the prediction of postnatal renal function in fetuses with solitary functioning kidney (SFK).

Methods: 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).

Results: 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 m2 , 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.

Conclusion: 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.

MeSH terms

  • Adolescent
  • Adult
  • Case-Control Studies
  • Female
  • Humans
  • Kidney / diagnostic imaging*
  • Organ Size
  • Pregnancy
  • Renal Circulation*
  • Solitary Kidney / diagnostic imaging*
  • Ultrasonography, Prenatal*
  • Young Adult