Prenatal detection of congenital renal disease.

Prenatal ultrasonography can identify not only the structural aspects of many abnormalities of the urinary tract but also associated anomalies, some of which may be missed even after birth. Prenatal imaging alerts physicians to some infants with urinary tract lesions that ordinarily show no physical findings at birth, leading to earlier diagnosis. An early diagnosis may prevent the first urinary tract infection in an infant at risk. In addition, there are fewer hospitalizations for infection or electrolyte abnormalities in infants with urinary tract disease. Elective surgery may be planned instead of performed on an urgent basis and thus can be performed with lower morbidity. Although the early diagnosis and treatment of pediatric renal disease have certainly been facilitated by prenatal ultrasonography, longer follow-up is required to determine whether prenatal detection prevents the onset of chronic renal failure as children with congenital renal disease approach adolescence and adult life.