Hyperechogenic Fetal Kidneys: Uncertain Diagnosis and Unpredictable Future?

Abstract

Glomerulocystic kidney with increased renal echogenicity encompasses a number of renal abnormalities that might have cystic glomeruli and be a sequelae of renal obstruction. Increased echogenicity of the kidneys is a non-specific finding and a result of varied etiologies. Multiple microscopic cortical and medullary cysts, interstitial fibrosis and mesangial sclerosis are the etiopathogenesis for renal hyperechogenicity even in the absence of macrocysts. The crucial point is poor predictability of antenatal ultrasound to fully define the extent and severity of parenchymal damage and to forecast its outcome at the time of initial diagnosis. The only exception is the most severe forms of cystic dysplasia associated with severe oligohydramnios. Urinary levels of β2-microglobulin may be a valuable marker of fetal renal function. Hyperechogenic fetal kidneys may have varied etiologies and within each etiological group there may have a wide range of outcomes. Challenges lie in counseling after antenatal diagnosis of fetal hyperechogenic kidneys which carry an uncertain course and prognosis.

Keywords

Hyperechogenicity - Poor predictability - Parenchymal damage - β2-Microglobulin - Challenge - Counseling

Publication History

Received: 02 June 2020

Accepted: 10 August 2020

Article published online:
05 May 2023