Die fetale und neonatale Nierenfunktion

Zusammenfassung

Die hochauflösende Sonographie erlaubt eine zunehmend präzise pränatale Diagnose von fetalen Harntransportstörungen. Angesichts verschiedener Optionen einer intrauterinen Intervention ist es Ziel zahlreicher Studien, die fetale Nierenfunktion zu bestimmen und die Prognose konnataler Harntraktfehlbildungen abzuschätzen. Im vorliegenden Artikel wird die Entwicklung der fetalen Nierenfunktion aufgezeichnet und die Möglichkeiten der Labor- und Ultraschalldiagnostik dargestellt. Angesichts hoher Risiken pränataler Interventionen wird ferner die Bedeutung dieser Befunde für das klinische Management diskutiert, um schließlich eine praktische Entscheidungshilfe aufzuzeichnen.

Abstract

High-resolution sonography provides the opportunity for prenatal detection of fetal anomalies of the urinary tract. In view of various options of prenatal urinary diversion to alleviate obstruction, it has become a scientific goal to measure fetal renal function and to determine the prognosis of urinary tract malformations. The article outlines the accumulated knowledge of the development of fetal renal function and the diagnostic possibilities offered by sonography and by laboratory test with focus on the chemistry of the amniotic fluid. Taking into consideration the high risks of prenatal intervention, these findings are discussed as to their relevance for the clinical management of pregnancies complicated by fetal urinary tract abnormalities. Lastly, criteria are proposed for the decision making in clinical practice.

Schlüsselwörter

Nierenfunktion - Fötus - Frühgeburt - Harntraktanomalie

Key words

Kidney function - fetus - premature neonate - urinary tract abnormality

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