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Early detection of congenital anomalies of the kidney and urinary tract: cross-sectional results of a community-based screening and referral study in China 期刊论文

编号：

91cdbcb1-a4d8-41e4-a40a-12dc0ddc15ab
作者：

Gong, Yinv^[1,2];Zhang, Ying^[3];Shen, Qian(沈茜)^[1,2]Xiao, Liping^[3];Zhai, Yihui^[1,2];Bi, Yunli^[4];Shen, Jian^[4];Chen, Hong^[4];Li, Yun^[3];Xu, Hong(徐虹)*^[1,2]
语种：

English
期刊：

BMJ OPEN ISSN：2044-6055 2018 年 8 卷 5 期 ; MAY
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摘要：

Objective To establish an effective screening model of congenital anomalies of the kidney and urinary tract (CAKUT) using ultrasound among neonates in Shanghai, China. Design Cross-sectional study. Setting A three-level screening model for CAKUT in neonates based on the child healthcare system was established since 2010 in Minhang District, Shanghai, China. Participants During 2010-2015, neonates with criteria such as preterrn, low birth weight and so on were eligible to participate in the study. Cases with renal pelvis dilatation (RPD) and other abnormal renal findings were managed based on presumed strategies. Main outcome measures The proportion of RPD and other renal and urinary tract anomalies; number of diagnosed CAKUT under integrated management, especially obstructive uropathy. The anterior-posterior renal pelvic diameter (APRPD) cut-off points for likelihood of obstructive uropathy and need for surgery. Results A total of 8827 infants were consecutively screened. Absolute and relative rates of different degrees of RPD classified by APRPD were: mild (5-9.9 mm), 984 (11.1%); moderate (10-14.9 mm), 176 (2.0%); severe (>= 15 mm), 20 (0.2%). Of 639 followed cases with RPD, 11 were diagnosed as obstructive uropathies. Of these, nine patients underwent surgery, at median age 2 months. A total 85.4% of mild, 62.5% of moderate and 30.0% of severe RPD cases resolved spontaneously. Other renal and urinary morphological abnormalities were diagnosed in 15 (0.2%) patients. The APRPD cut-off points for significant obstructive uropathy and need for surgery were 9.7 mm and 13.5mm, respectively. Conclusions This three-level screening model is an effective and feasible strategy for early detection and intervention of CAKUT in the early postnatal period, especially for patients with high-grade RPD and other renal and urinary malformations. This strategy could be useful in China and other developing areas with limited medical resources.
推荐引用方式
GB/T 7714：

Gong Yinv,Zhang Ying,Shen Qian, et al. Early detection of congenital anomalies of the kidney and urinary tract: cross-sectional results of a community-based screening and referral study in China [J].BMJ OPEN,2018,8(5).
APA：

Gong Yinv,Zhang Ying,Shen Qian,Xiao Liping,&Xu Hong.(2018).Early detection of congenital anomalies of the kidney and urinary tract: cross-sectional results of a community-based screening and referral study in China .BMJ OPEN,8(5).
MLA：

Gong Yinv, et al. "Early detection of congenital anomalies of the kidney and urinary tract: cross-sectional results of a community-based screening and referral study in China" .BMJ OPEN 8,5(2018).

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