PD55-06 EARLY PRENATAL DETECTION OF LUTO IS ASSOCIATED WITH INCREASED RISK OF KIDNEY TRANSPLANTATION—A MULTI-INSTITUTIONAL TRANS-ATLANTIC EXPERIENCE

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You have accessJournal of UrologyPediatrics VI (PD55)1 May 2024PD55-06 EARLY PRENATAL DETECTION OF LUTO IS ASSOCIATED WITH INCREASED RISK OF KIDNEY TRANSPLANTATION—A MULTI-INSTITUTIONAL TRANS-ATLANTIC EXPERIENCE Franziska Juliane Richter, Luke Harper, Silvia Pecorelli, Massimo Garriboli, Giulia Lanfranchi, Hayley Good, Joana Dos Santos, Jin K. Kim, Shiri Shinar, Tim Van Mieghem, Armando J. Lorenzo, and Mandy Rickard Franziska Juliane RichterFranziska Juliane Richter , Luke HarperLuke Harper , Silvia PecorelliSilvia Pecorelli , Massimo GarriboliMassimo Garriboli , Giulia LanfranchiGiulia Lanfranchi , Hayley GoodHayley Good , Joana Dos SantosJoana Dos Santos , Jin K. KimJin K. Kim , Shiri ShinarShiri Shinar , Tim Van MieghemTim Van Mieghem , Armando J. LorenzoArmando J. Lorenzo , and Mandy RickardMandy Rickard View All Author Informationhttps://doi.org/10.1097/01.JU.0001008908.82706.9f.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prenatal detection of lower urinary tract obstruction (LUTO) early in pregnancy is thought to be associated with poor postnatal outcomes. However, there is limited evidence on postnatal prognosis when detected in the 2nd or 3rd trimester with respect to progression to chronic kidney disease (CKD) and renal replacement therapy. Herein, we aim to determine prevalence and trends of CKD, end stage kidney disease (ESKD) and transplantation in prenatally-detected LUTO patients stratified by trimester of diagnosis. METHODS: Following multi-institutional review of prenatal LUTO cases from France, England and Canada, patients were assigned to groups based on time of first detection (2nd or 3rd trimester). Assessed variables included prematurity, creatinine and eGFR levels at first visit (baseline), 1 and 5 years of age and last follow-up, and progression to transplantation/ESKD. RESULTS: LUTO was suspected in 124 male patients during the second (n=57, 20.0 weeks, IQR 13, 27) or third trimester (n=67, 32.0 weeks, IQR 27, 38). Median creatinine levels at baseline (p=0.4256), 1 year of age (p=0.0759) and after 5 years (p=0.2505) as well as progression to CKD3-4 (p>0.9999) were similar. However, progression to renal replacement therapy was more pronounced in the second trimester vs. third trimester groups, and 2nd trimester progression was significantly worse for transplantation and ESKD/CKD5 (Dialysis: 13.6% vs. 2.4% [p=0.0685]; transplantation: 15.8% vs. 2.9% [p=0.0227] and ESKD/CKD5: 37% vs. 10.7% [p=0.0286]) at median follow up of 54.5 and 59.8 months, respectively (Table 1). CONCLUSIONS: Detection of LUTO during the second trimester appears to portent worse outcomes during childhood, as reflected by significantly increased rates of kidney transplantation. As we accrue more data, validation will carry important prognostic and counseling implications. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1152 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Franziska Juliane Richter More articles by this author Luke Harper More articles by this author Silvia Pecorelli More articles by this author Massimo Garriboli More articles by this author Giulia Lanfranchi More articles by this author Hayley Good More articles by this author Joana Dos Santos More articles by this author Jin K. Kim More articles by this author Shiri Shinar More articles by this author Tim Van Mieghem More articles by this author Armando J. Lorenzo More articles by this author Mandy Rickard More articles by this author Expand All Advertisement PDF downloadLoading ...

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