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10.1007/s00431-017-2964-2

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suck abstract from ncbi


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pmid28730318
      Eur+J+Pediatr 2017 ; 176 (9 ): 1209-1215
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  • Renal function in neonates with twin-twin transfusion syndrome treated with or without fetoscopic laser surgery #MMPMID28730318
  • Verbeek L ; Joemmanbaks FA ; Quak JME ; Sukhai RN ; Middeldorp JM ; Oepkes D ; Lopriore E
  • Eur J Pediatr 2017[Sep]; 176 (9 ): 1209-1215 PMID28730318 show ga
  • 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 ?mol/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 ?mol/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 ?mol/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.
  • |Acute Kidney Injury/blood/epidemiology/*etiology [MESH]
  • |Case-Control Studies [MESH]
  • |Conservative Treatment [MESH]
  • |Creatinine/blood [MESH]
  • |Female [MESH]
  • |Fetofetal Transfusion/complications/diagnosis/*surgery [MESH]
  • |Fetoscopy/*methods [MESH]
  • |Gestational Age [MESH]
  • |Humans [MESH]
  • |Infant, Newborn [MESH]
  • |Laser Therapy/adverse effects/*methods [MESH]
  • |Male [MESH]
  • |Oliguria/epidemiology/etiology [MESH]
  • |Pregnancy [MESH]
  • |Pregnancy, Twin [MESH]
  • |Retrospective Studies [MESH]
  • |Risk [MESH]
  • |Urea/blood [MESH]


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