Original Article Antenatal oligohydramnios of renal origin: long-term outcome

Background. Prognosis of fetuses with renal oligohy-dramnios (ROH) is often still regarded as poor. Neonatal complications and the long-term follow-up of fetuses with ROH in two pediatric centres are described. Method. 23 fetuses (16 males, 7 females) were included as patients. Primary diseases included congenital anomalies of the kidney and urinary tract (n 16), autosomal recessive polycystic kidney disease (n 4) and renal tubular dysgenesis (n 3). The analysis includes retrospective chart review. Results. Seven children died (30%), the majority (n 4, 17%) within the neonatal period due to pulmonary hypoplasia and renal insufficiency. Fourteen patients (61%) required postnatal mechan-ical ventilation for a median of 4 (range 1–60) days; 11 infants had an associated pneumothorax. All 16 surviving children have chronic kidney disease (CKD) at a current median age of 5.7 years (range 0.5–14.5), managed conservatively in eight patients [median glome-rular filtration rate 51 (range 20–78) ml/min/1.73m2]. Eight patients reached end-stage renal disease at a median age of 0.3 years (range 2 days to 8.3 years), including one patient with pre-emptive kidney transplantation. Five of the patients requiring dialysis underwent successful renal transplantation at a median age of 3.5 years (range 2.5–4). Growth was impaired in seven children requiring growth hormone treatment. Cognitive and motor development was normal in 12 (75%) of the 16 patients and showed a delay in four children, including two with associated syndromal features. Conclusion. ROH is not always associated with a poor prognosis and long-term outcome in survivors is encouraging. The high incidence of neonatal complica-tions and long-term morbidity due to CKD requires a multidisciplinary management of these children