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Prognostic factors in fetal hydronephrosis: a multivariate analysis
E A Oliveira1, J S Diniz, A C Cabral
1Pediatric Nephrourology Unit, Department of Pediatrics, Hospital das Clinicas, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil. eduolive@medicina.ufmg.br
Pediatric Nephrology (Berlin, Germany)
|December 22, 1999
Summary
Oligohydramnios, prematurity, and low glomerular filtration rate are key predictors of adverse outcomes in fetal hydronephrosis. Early identification and specialized care are crucial for affected newborns.
Area of Science:
- Pediatric Nephrology
- Fetal Medicine
- Neonatal Urology
Background:
- Obstetric echography has increased the detection rate of fetal hydronephrosis.
- Identifying prognostic factors for adverse outcomes in fetal hydronephrosis is critical for appropriate management.
Purpose of the Study:
- To identify prognostic factors associated with adverse outcomes, including renal failure and death, in infants diagnosed with fetal hydronephrosis.
Main Methods:
- Prospective follow-up of 148 children with fetal hydronephrosis.
- Univariate analysis using the Kaplan-Meier method to identify associated variables.
- Multivariate Cox's proportional hazards model to determine independent predictors of adverse outcomes.
Main Results:
- Oligohydramnios, prematurity, and a glomerular filtration rate (GFR) below 20 ml/min were identified as independent predictors of adverse outcomes.
- These factors significantly correlated with increased risk of renal failure and mortality.
Conclusions:
- Oligohydramnios, prematurity, and impaired renal function (GFR < 20 ml/min) are critical indicators for poor prognosis in fetal hydronephrosis.
- Infants presenting with these factors require specialized follow-up and management in centers equipped for neonatal uropathy care.