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- Title
Predictive value of amniotic fluid cystatin C levels for the early identification of fetuses with obstructive uropathies
- Authors
Mussap, Michele; Fanos, Vassilios; Pizzini, Carla; Marcolongo, Alma; Chiaffoni, Graziella; Plebani, Mario
- Abstract
: ObjectiveTo compare the diagnostic accuracy of cystatin C with that of creatinine in discriminating renal function in fetuses without ultrasononographic evidence of renal malformations from those with obstructive uropathies.: DesignProspective, observational cohort study.: SettingPrenatal morphologic and functional evaluation of fetal obstructive uropathies throughout pregnancy.: PopulationA total of 96 healthy pregnant women at different stages of pregnancy, without any pregnancy-related maternal disease. Eighty-one pregnant women without clinical and ultrasonographic evidence of any fetal anomaly, confirmed at birth, were defined as controls; 15 pregnant women with various fetal obstructive uropathies, evidenced by repeated ultrasound examinations and confirmed at birth, were defined as cases.: MethodsCreatinine was measured by a kinetic Jaffe picric acid method and cystatin C by a nephelometric immunoassay. Variables were analysed by applying conventional statistical tests; the non-parametric receiver operating curves (ROC) analysis was used to evaluate the diagnostic efficiencies of the biochemical markers.: Main outcome measuresIncidence of confirmed, diagnosed, neonatal obstructive uropathy by measuring baseline levels of cystatin C and creatinine in amniotic fluid.: ResultsBaseline levels of cystatin C in amniotic fluid were significantly higher (P = 0.0015) among cases than in controls with comparable gestational age; no significant difference was found for creatinine levels (P = n.s.). The maximum diagnostic accuracy of serum cystatin C in discriminating controls from fetal uropathies was 96%, while that of creatinine was 62%.: ConclusionCystatin C may be considered a sensitive biochemical marker for the early identification of fetuses with obstructive uropathies.
- Subjects
CREATININE; FETUS; ULTRASONIC imaging; KIDNEY diseases
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2002, Vol 109, Issue 7, p778
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/j.1471-0528.2002.01430.x