Renal function in neonates with twin-twin transfusion syndrome treated with or without fetoscopic laser surgery.
Eur J Pediatr
; 176(9): 1209-1215, 2017 Sep.
Article
em En
| MEDLINE
| ID: mdl-28730318
ABSTRACT
The aim of this study is to investigate the short-term renal function in neonates with twin-twin transfusion syndrome (TTTS), treated with fetoscopic laser surgery (laser group) or conservatively (non-laser group). Creatinine and urea levels and urine output were recorded in the first week after birth. Primary outcome was short-term renal dysfunction, defined as a creatinine level of >100 µmol/L during the first week postpartum. We evaluated 312 twins (laser group, n = 274; non-laser group, n = 38). Median creatinine and urea levels were lower in the laser group than in the non-laser group (71 versus 82 µmol/L, p = 0.002). Short-term renal dysfunction was lower in the laser group compared to the non-laser group (7.2 versus 34.4%, p < 0.001). Within the laser group, creatinine levels were significantly higher in the subgroup with incomplete laser surgery compared to twins with successful laser surgery (76 versus 69 µmol/L, p = 0.018). No differences were found between donors and recipients except for a higher incidence of oliguria in donors in the non-laser group on day 1. CONCLUSION:
Short-term renal dysfunction occurs less frequently in TTTS twins treated with fetoscopic laser coagulation, particularly after complete surgery, suggesting that laser surgery may have a protective effect on renal function. What is Known ⢠Antenatally, donor twins in TTTS have severe oliguria due to chronic hypovolemia and impaired renal perfusion ⢠Postnatally, donor twins may suffer from severe renal complications, particularly in TTTS twins treated conservatively. What is New ⢠The incidence of short-term renal failure in TTTS twins treated with complete laser surgery is low. ⢠After incomplete laser surgery, the incidence of short-term renal dysfunction is increased.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Terapia a Laser
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Injúria Renal Aguda
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Transfusão Feto-Fetal
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Fetoscopia
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Newborn
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Pregnancy
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article