The RAFT cohort showed a bridge to dialysis—not a short road home

In 32 selected pregnancies with early anhydramnios from fetal kidney failure, 19 of 29 live-born infants reached 14 days with dialysis access. Fourteen survived to discharge after a median 4.7 months, and every live birth was preterm.

THE HOT TAKE

The cohort shows that some infants can cross the first lung-survival hurdle. It does not make the road through dialysis, discharge, and transplant look short.

RAFT prospectively followed 32 highly selected maternal-fetal pairs at 13 US fetal-therapy centers. Each pregnancy had anhydramnios before 22 weeks from fetal kidney failure other than bilateral renal agenesis, and serial ultrasound-guided isotonic-fluid amnioinfusions began before 26 weeks. This was a nonrandomized intervention cohort, not a comparison against usual care.

The bars are successive absolute counts, not four percentages with one denominator. Twenty-nine of 32 pregnancies produced a live birth. The prespecified primary endpoint—survival for at least 14 days plus dialysis-access placement—was then assessed among those 29 live-born neonates and occurred in 19.