Kimar et al identified factors associated with a worse prognosis for an infant with a fetal renal anomaly. These can help to identify a patient who may benefit from more aggressive management. The authors are from Lady Hardinge Medical College, Fortis La Femme Hospital and All India Institute of Medical Sciences in New Delhi.
Patient selection: infant with a renal anomaly/malformation
Predictors of worse prognosis:
(1) bilateral renal anomalies, especially if cystic
(2) oligohydramnios
(3) extra-renal malformation (cranio-vertebral defect, polydactyly, skeletal anomaly, other), especially if multiple
Intra-uterine growth retardation (IUGR) by itself was not associated with poor survival.
Outcome is affected by available resources and severity of comorbid conditions. Survival in a resource poor setting is worse. Early referral to a tertiary children’s hospital can improve survival.
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