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A single-center study to evaluate the efficacy of a fetal urine peptide signature predicting postnatal renal outcome in fetuses with posterior urethral valves.
Pediatric Nephrology ( IF 2.6 ) Pub Date : 2019-11-07 , DOI: 10.1007/s00467-019-04390-9
Bénédicte Buffin-Meyer 1, 2 , Marcin Tkaczyk 3 , Małgorzata Stańczyk 3 , Benjamin Breuil 1, 2 , Justyna Siwy 4 , Krzysztof Szaflik 5 , Tomasz Talar 6 , Justyna Wojtera 5 , Waldemar Krzeszowski 5 , Stéphane Decramer 1, 2, 7, 8 , Julie Klein 1, 2 , Joost P Schanstra 1, 2
Affiliation  

BACKGROUND Posterior urethral valves (PUVs) account for 17% of pediatric renal failure. The management of pregnancies involving fetuses with PUV is hampered by the fact that current clinical parameters obtained from fetal ultrasound and/or fetal urine biochemistry are insufficient to predict postnatal renal function. We previously have developed a fetal urine peptide signature (12PUV) that predicted with high precision postnatal renal failure at 2 years of age in fetuses with PUV. Here, we evaluated the accuracy of this signature to predict postnatal renal outcome in fetuses with PUV in an independent single-center study. METHODS Thirty-three women carrying fetuses with suspected PUV were included. Twenty-five fetuses received vesicoamniotic shunts during pregnancy. PUV was confirmed postnatally in 23 patients. Of those 23 fetuses, 2 were lost in follow-up. Four and 3 patients died in the pre- and perinatal periods, respectively. Follow-up renal function at 6 months of age was obtained for the remaining 14 patients. The primary outcome was early renal failure, defined by an eGFR < 60 mL/min/1.73 m2 before 6 months of age or pre- or perinatal death. RESULTS The peptide signature predicted postnatal renal outcome in postnatally confirmed PUV fetuses with an AUC of 0.94 (95%CI 0.74-1.0) and an accuracy of 90% (95%CI 78-100). The signature predicted postnatal renal outcome for the suspected PUV cases with an AUC of 0.89 (95%CI 0.72-0.97) and an accuracy of 84% (95%CI 71-97). CONCLUSIONS This single-center study confirms the predictive power of the previously identified 12PUV fetal urinary peptide signature.

中文翻译:

一项评估胎儿尿肽标记物的功效的单中心研究,预测尿道后瓣膜胎儿的出生后肾结局。

背景技术后尿道瓣膜(PUVs)占小儿肾功能衰竭的17%。从胎儿超声和/或胎儿尿生化获得的当前临床参数不足以预测出生后的肾功能这一事实妨碍了对妊娠合并PUV的胎儿的管理。我们以前已经开发出了一种胎儿尿肽签名(12PUV),可预测2岁的PUV胎儿在出生后肾功能衰竭时的精确度高。在一项独立的单中心研究中,我们评估了该签名预测PUV胎儿产后肾脏结局的准确性。方法纳入33例携带疑似PUV胎儿的妇女。25名胎儿在怀孕期间接受了膀胱羊膜分流术。出生后证实有23例PUV。在这23胎中 2名在随访中丢失。分别有4名和3名患者在产前和围产期死亡。其余14名患者获得了6个月大的随访肾功能。主要结局是早期肾衰竭,定义为6个月大前eGFR <60 mL / min / 1.73 m2或产前或围产期死亡。结果该肽标记可预测出生后确诊的PUV胎儿的出生后肾结局,其AUC为0.94(95%CI 0.74-1.0),准确度为90%(95%CI 78-100)。该签名预测了疑似PUV病例的产后肾结局,其AUC为0.89(95%CI 0.72-0.97),准确度为84%(95%CI 71-97)。结论这项单中心研究证实了先前确定的12PUV胎儿尿肽标记的预测能力。分别有4名和3名患者在产前和围产期死亡。其余14名患者获得了6个月大的随访肾功能。主要结局是早期肾衰竭,定义为6个月大前eGFR <60 mL / min / 1.73 m2或产前或围产期死亡。结果该肽标记可预测出生后确诊的PUV胎儿的出生后肾结局,其AUC为0.94(95%CI 0.74-1.0),准确度为90%(95%CI 78-100)。该签名预测了疑似PUV病例的产后肾结局,其AUC为0.89(95%CI 0.72-0.97),准确度为84%(95%CI 71-97)。结论这项单中心研究证实了先前确定的12PUV胎儿尿肽标记的预测能力。分别有4名和3名患者在产前和围产期死亡。其余14名患者获得了6个月大的随访肾功能。主要结局是早期肾衰竭,定义为6个月大前eGFR <60 mL / min / 1.73 m2或产前或围产期死亡。结果该肽标记可预测出生后确诊的PUV胎儿的出生后肾结局,其AUC为0.94(95%CI 0.74-1.0),准确度为90%(95%CI 78-100)。该签名预测了疑似PUV病例的产后肾结局,其AUC为0.89(95%CI 0.72-0.97),准确度为84%(95%CI 71-97)。结论这项单中心研究证实了先前确定的12PUV胎儿尿肽标记的预测能力。其余14名患者获得了6个月大的随访肾功能。主要结局是早期肾衰竭,定义为6个月大前eGFR <60 mL / min / 1.73 m2或产前或围产期死亡。结果该肽标记可预测出生后确诊的PUV胎儿的出生后肾结局,其AUC为0.94(95%CI 0.74-1.0),准确度为90%(95%CI 78-100)。该签名预测了疑似PUV病例的产后肾脏预后,AUC为0.89(95%CI 0.72-0.97),准确度为84%(95%CI 71-97)。结论这项单中心研究证实了先前确定的12PUV胎儿尿肽标记的预测能力。其余14名患者获得了6个月大的随访肾功能。主要结局是早期肾衰竭,定义为6个月大前eGFR <60 mL / min / 1.73 m2或产前或围产期死亡。结果该肽标记可预测出生后确诊的PUV胎儿的出生后肾结局,其AUC为0.94(95%CI 0.74-1.0),准确度为90%(95%CI 78-100)。该签名预测了疑似PUV病例的产后肾结局,其AUC为0.89(95%CI 0.72-0.97),准确度为84%(95%CI 71-97)。结论这项单中心研究证实了先前确定的12PUV胎儿尿肽标记的预测能力。结果该肽标记可预测出生后确诊的PUV胎儿的出生后肾结局,其AUC为0.94(95%CI 0.74-1.0),准确度为90%(95%CI 78-100)。该签名预测了疑似PUV病例的产后肾结局,其AUC为0.89(95%CI 0.72-0.97),准确度为84%(95%CI 71-97)。结论这项单中心研究证实了先前确定的12PUV胎儿尿肽标记的预测能力。结果该肽标记可预测出生后确诊的PUV胎儿的出生后肾结局,其AUC为0.94(95%CI 0.74-1.0),准确度为90%(95%CI 78-100)。该签名预测了疑似PUV病例的产后肾脏预后,AUC为0.89(95%CI 0.72-0.97),准确度为84%(95%CI 71-97)。结论这项单中心研究证实了先前确定的12PUV胎儿尿肽标记的预测能力。
更新日期:2020-01-17
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