BACKGROUND Amongst other sequelae, acute kidney injury (AKI) is a well-recognised post-natal complication of twin-to-twin transfusion syndrome (TTTS). Despite this, there has been a lack of data reporting long-term renal outcomes. Our aim was to report the long-term renal outcomes of infants born with TTTS. METHODS We performed a retrospective case note review of all infants referred to our centre between 1998 and 2018 with a primary diagnosis of TTTS. Subjects with confirmed TTTS were divided into a chronic kidney disease (CKD) group and a non-CKD group for comparison. RESULTS Twenty-six infants with TTTS were included for analysis. Eight (31%) subjects developed CKD. Within the CKD group, 50% went on to require long-term renal replacement therapy (RRT) of whom all underwent renal transplantation. For subjects who had neonatal AKI, cumulative survival rate before RRT at 5 and 10 years was 79% and 70%, respectively. Subjects with CKD had a significantly higher incidence of AKI in the neonatal period and were more likely to be the donor twin. Gestational age at birth, gender, antenatal interventions and comorbidities did not affect long-term renal outcome between the two groups. CONCLUSION This is the first long-term follow-up study demonstrating that CKD progressing to the need for RRT can develop after TTTS. Donor-twin status and neonatal AKI associated with adverse long-term outcomes warranting long-term surveillance in this group.

中文翻译：

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双胎双输血综合征引起的慢性肾脏疾病的长期结果。

背景技术在其他后遗症中，急性肾脏损伤（AKI）是公认的双胎双输血综合征（TTTS）的产后并发症。尽管如此，仍然缺乏报告长期肾结局的数据。我们的目的是报告TTTS婴儿的长期肾脏结局。方法我们对1998年至2018年间转诊至我中心且初次诊断为TTTS的所有婴儿进行了回顾性病例笔记审查。TTTS确诊的受试者被分为慢性肾脏疾病（CKD）组和非CKD组进行比较。结果纳入26例TTTS婴儿进行分析。八名（31％）受试者患有CKD。在CKD组中，有50％的患者需要接受长期肾脏替代疗法（RRT），所有这些患者均接受了肾脏移植。对于患有新生儿AKI的受试者，RRT在5年和10年时的累计生存率分别为79％和70％。CKD患者在新生儿期的AKI发生率明显更高，并且更有可能是双胞胎供体。出生时的胎龄，性别，产前干预措施和合并症均未影响两组之间的长期肾脏结局。结论这是第一个长期的随访研究，表明TTTS后可发展为CKD，发展为需要RRT。供体双胞胎状态和新生儿AKI与不良的长期预后相关，因此值得长期监测。产前干预和合并症并未影响两组之间的长期肾脏结局。结论这是第一个长期的随访研究，表明TTTS后可发展为CKD，发展为需要RRT。供体双胎状态和新生儿AKI与不良的长期预后相关，因此值得长期监测。产前干预和合并症并未影响两组之间的长期肾脏结局。结论这是第一个长期的随访研究，表明TTTS后可发展为CKD，发展为需要RRT。供体双胎状态和新生儿AKI与不良的长期预后相关，因此值得长期监测。