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Fetal hyperechoic kidney cohort study and a meta-analysis

Objective: To investigate the positive rate of chromosomal and monogenic etiologies and pregnancy outcomes in fetuses with hyperechoic kidney, and to provide more information for genetic counseling and prognosis evaluation. Methods: We performed a retrospective analysis of 25 cases of hyperechoic ki...

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Autores principales: Yang, Wei, Zu, Shujing, Jin, Qiu, Liu, Yu, Wang, Chao, Shen, Huimin, Wang, Ruijing, Zhang, Hui, Liu, Meimei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469696/
https://www.ncbi.nlm.nih.gov/pubmed/37662847
http://dx.doi.org/10.3389/fgene.2023.1237912
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author Yang, Wei
Zu, Shujing
Jin, Qiu
Liu, Yu
Wang, Chao
Shen, Huimin
Wang, Ruijing
Zhang, Hui
Liu, Meimei
author_facet Yang, Wei
Zu, Shujing
Jin, Qiu
Liu, Yu
Wang, Chao
Shen, Huimin
Wang, Ruijing
Zhang, Hui
Liu, Meimei
author_sort Yang, Wei
collection PubMed
description Objective: To investigate the positive rate of chromosomal and monogenic etiologies and pregnancy outcomes in fetuses with hyperechoic kidney, and to provide more information for genetic counseling and prognosis evaluation. Methods: We performed a retrospective analysis of 25 cases of hyperechoic kidney diagnosed prenatal in the Second Affiliated Hospital of Harbin Medical University and Harbin Red Cross Central Hospital (January 2017–December 2022). Furthermore, we conducted a meta-analysis of a series of hyperechoic kidneys (HEK) in the literature to assess the incidence of chromosomal and monogenic etiologies, mortality, and pooled odds ratio (OR) estimates of the association between the incidence of these outcomes and other associated ultrasound abnormalities. Results: 25 fetuses of HEK were enrolled in the cohort study, including 14 with isolated hyperechoic kidney (IHK) and 11 with non-isolated hyperechoic kidney (NIHK). Chromosomal aneuploidies were detected in 4 of 20 patients (20%). The detection rate of pathogenic or suspected pathogenic copy number variations (CNVs) was 29% (4/14) for IHK and 37% (4/11) for NIHK. Whole exome sequencing (WES) was performed in 5 fetuses, and pathogenic genes were detected in all of them. The rate of termination of pregnancy was 56% in HEK. 21 studies including 1,178 fetuses were included in the meta-analysis. No case of abnormal chromosome karyotype or (intrauterine death)IUD was reported in fetuses with IHK. In contrast, the positive rate of karyotype in NIHK was 22% and that in HEK was 20%, with the ORs of 0.28 (95% CI 0.16–0.51) and 0.25, (95% CI 0.14–0.44), respectively. The positive rate of (chromosome microarray analysis) CMA in IHK was 59% and that in NIHK was 32%, with the ORs of 1.46 (95% CI 1.33–1.62) and 0.48 (95% CI, 0.28–0.85), respectively. The positive rate of monogenic etiologies in IHK was 31%, with the OR of 0.80 (95% CI 0.25–2.63). In IHK, the termination rate was 21% and neonatal mortality was 13%, with the ORs of 0.26 (95% CI, 0.17–0.40), 1.72 (95% CI, 1.59–1.86), and that in NIHK was 63%, 0.15 (95% CI, 0.10–0.24); 11%, 0.12 (95% CI, 0.06–0.26), respectively. The intrauterine mortality in NIHK group was 2%, with the OR of 0.02 (95% CI, 0.01–0.05). HNF1B variant has the highest incidence (26%) in IHK. Conclusion: The positive rate of karyotype was 20% in HEK and 22% in NIHK. The positive rate of CMA was 32% in NIHK and 59% in IHK. The positive rate of IHK monogenic etiologies was 31%. HNF1B gene variation is the most common cause of IHK. The overall fetal mortality rate of NIHK is significantly higher than that of IHK. The amount of amniotic fluid, kidney size and the degree of corticomedullary differentiation have a great impact on the prognosis, these indicators should be taken into consideration to guide clinical consultation and decision-making.
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spelling pubmed-104696962023-09-01 Fetal hyperechoic kidney cohort study and a meta-analysis Yang, Wei Zu, Shujing Jin, Qiu Liu, Yu Wang, Chao Shen, Huimin Wang, Ruijing Zhang, Hui Liu, Meimei Front Genet Genetics Objective: To investigate the positive rate of chromosomal and monogenic etiologies and pregnancy outcomes in fetuses with hyperechoic kidney, and to provide more information for genetic counseling and prognosis evaluation. Methods: We performed a retrospective analysis of 25 cases of hyperechoic kidney diagnosed prenatal in the Second Affiliated Hospital of Harbin Medical University and Harbin Red Cross Central Hospital (January 2017–December 2022). Furthermore, we conducted a meta-analysis of a series of hyperechoic kidneys (HEK) in the literature to assess the incidence of chromosomal and monogenic etiologies, mortality, and pooled odds ratio (OR) estimates of the association between the incidence of these outcomes and other associated ultrasound abnormalities. Results: 25 fetuses of HEK were enrolled in the cohort study, including 14 with isolated hyperechoic kidney (IHK) and 11 with non-isolated hyperechoic kidney (NIHK). Chromosomal aneuploidies were detected in 4 of 20 patients (20%). The detection rate of pathogenic or suspected pathogenic copy number variations (CNVs) was 29% (4/14) for IHK and 37% (4/11) for NIHK. Whole exome sequencing (WES) was performed in 5 fetuses, and pathogenic genes were detected in all of them. The rate of termination of pregnancy was 56% in HEK. 21 studies including 1,178 fetuses were included in the meta-analysis. No case of abnormal chromosome karyotype or (intrauterine death)IUD was reported in fetuses with IHK. In contrast, the positive rate of karyotype in NIHK was 22% and that in HEK was 20%, with the ORs of 0.28 (95% CI 0.16–0.51) and 0.25, (95% CI 0.14–0.44), respectively. The positive rate of (chromosome microarray analysis) CMA in IHK was 59% and that in NIHK was 32%, with the ORs of 1.46 (95% CI 1.33–1.62) and 0.48 (95% CI, 0.28–0.85), respectively. The positive rate of monogenic etiologies in IHK was 31%, with the OR of 0.80 (95% CI 0.25–2.63). In IHK, the termination rate was 21% and neonatal mortality was 13%, with the ORs of 0.26 (95% CI, 0.17–0.40), 1.72 (95% CI, 1.59–1.86), and that in NIHK was 63%, 0.15 (95% CI, 0.10–0.24); 11%, 0.12 (95% CI, 0.06–0.26), respectively. The intrauterine mortality in NIHK group was 2%, with the OR of 0.02 (95% CI, 0.01–0.05). HNF1B variant has the highest incidence (26%) in IHK. Conclusion: The positive rate of karyotype was 20% in HEK and 22% in NIHK. The positive rate of CMA was 32% in NIHK and 59% in IHK. The positive rate of IHK monogenic etiologies was 31%. HNF1B gene variation is the most common cause of IHK. The overall fetal mortality rate of NIHK is significantly higher than that of IHK. The amount of amniotic fluid, kidney size and the degree of corticomedullary differentiation have a great impact on the prognosis, these indicators should be taken into consideration to guide clinical consultation and decision-making. Frontiers Media S.A. 2023-08-17 /pmc/articles/PMC10469696/ /pubmed/37662847 http://dx.doi.org/10.3389/fgene.2023.1237912 Text en Copyright © 2023 Yang, Zu, Jin, Liu, Wang, Shen, Wang, Zhang and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Genetics
Yang, Wei
Zu, Shujing
Jin, Qiu
Liu, Yu
Wang, Chao
Shen, Huimin
Wang, Ruijing
Zhang, Hui
Liu, Meimei
Fetal hyperechoic kidney cohort study and a meta-analysis
title Fetal hyperechoic kidney cohort study and a meta-analysis
title_full Fetal hyperechoic kidney cohort study and a meta-analysis
title_fullStr Fetal hyperechoic kidney cohort study and a meta-analysis
title_full_unstemmed Fetal hyperechoic kidney cohort study and a meta-analysis
title_short Fetal hyperechoic kidney cohort study and a meta-analysis
title_sort fetal hyperechoic kidney cohort study and a meta-analysis
topic Genetics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469696/
https://www.ncbi.nlm.nih.gov/pubmed/37662847
http://dx.doi.org/10.3389/fgene.2023.1237912
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