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Short-Term Postnatal Renal Function in Twin Anemia-Polycythemia Sequence.

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Donor twins in twin anemia-polycythemia sequence (TAPS) show higher creatinine levels and increased risk of short-term renal dysfunction compared to recipients. Further studies are needed to assess long-term renal effects in TAPS donors.

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Area of Science:

  • Neonatal medicine
  • Perinatology
  • Pediatric nephrology

Background:

  • Twin anemia-polycythemia sequence (TAPS) is a complication of monochorionic twinning.
  • TAPS can lead to significant inter-twin disparities in blood volume and viscosity.
  • The impact of TAPS on neonatal renal function is not well understood.

Purpose of the Study:

  • To evaluate short-term renal function in neonates diagnosed with TAPS.
  • To compare renal function parameters between TAPS donor and recipient twins.
  • To identify potential risk factors for renal dysfunction in TAPS.

Main Methods:

  • Retrospective analysis of monochorionic twins with TAPS and double survivors from three European centers.
  • Matching of TAPS twin pairs with unaffected control twin pairs based on gestational age at birth.
  • Measurement of serum creatinine and urea levels within the first week postpartum; definition of short-term renal dysfunction as creatinine >100 μmol/l.

Main Results:

  • 52 TAPS twin pairs and 52 control pairs (median gestational age 31 weeks) were analyzed.
  • TAPS donor twins exhibited higher mean creatinine levels (85 μmol/l) than recipient twins (71 μmol/l) (p=0.001).
  • Short-term renal dysfunction occurred in 26.0% of TAPS donors versus 6.3% of recipients (p=0.022); no inter-twin differences were observed in controls.

Conclusions:

  • Donor twins with TAPS demonstrate elevated creatinine levels and a higher incidence of short-term renal dysfunction compared to recipients.
  • Chronic inter-twin transfusion in TAPS may contribute to acute kidney injury in donor neonates.
  • Long-term renal outcomes for TAPS donor twins warrant further investigation.