Prenatal diagnosis of hyperechogenic kidneys A study of 17 cases

Objectives - To evaluate the prenatal diagnosis and the prognostic value of ultrasound in case of fetal hyperechogenic kidneys Patients and 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 ultrasnographic criterion is specific of aetiology Five pregnancies were terminated We observed one neonatal death and 11 survivors (median follow up 30 months) 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 ammo tic fluid volume (nine children symptom free) Kidneys less or equal to +4S D and a normal amniotic fluid volume were associated with a good prognosis (n = 7, seven symptom free) Conclusion - 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 (C) 2010 Elsevier Masson SAS All rights reserved