Oligohydramnion : Immer eine infauste Prognose? (Leitthema)

Congenital renal failure is rare and predominantly caused by congenital anomalies of the kidneys and urinary tract and autosomal recessive polcystic kidney disease. Renal impairment in utero leads to oligohydramnios which may cause pulmonary hypoplasia. The prognosis has been regarded as poor, however, recently due to progress in neonatal intensive care and in renal replacement therapy the overall prognosis of children born after oligohydramnios has improved considerably. Most children survive and have favorable long-term outcome regarding growth and quality of life. When fetal renal impairment is suspected, a multidisciplinary counseling is necessary, including pediatric nephrologists. Mortality and morbidity is highest in the perinatal period, thus delivery in a center with an neonatal intensive care unit and possibility of renal replacement therapy is necessary. As all surviving children may have chronic kidney disease close follow-up by a pediatric nephrologist is essential. It should be emphasized, however, that not all children need renal replacement therapy. Long term-outcome and quality of life in children after oligohydramnios per se is favorable.