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Did antenatal diagnosis protect against chronic kidney disease in patients with posterior urethral valves? A multicenter study.

Abstract：

OBJECTIVE:To evaluate the prognostic role of antenatal diagnosis of posterior urethral valves (PUVs) on ultimate renal function. METHODS:Between 1990 and 2010, 315 patients with PUVs were diagnosed and treated at 2 separate tertiary centers. Primary valve ablation was performed in all patients except 18, who underwent initial vesicostomy. Patients were divided into two groups: group 1 included 144 patients who were diagnosed antenatally, and group 2 included 171 patients with a postnatal diagnosis. Long-term functional and radiologic outcomes were assessed. RESULTS:Follow-up was a median 5.5 years (range, 2-15 years). Mean age at ablation was 2.5 years (range, 1 day-15 years). Chronic kidney disease developed at the end of follow-up in 96 patients (30%): 27 (19%) in group 1 and 69 (40%) in group 2 (P <.05). The mean nadir serum creatinine was 0.6 and 0.8 mg/dL in groups 1 and 2, respectively, and the mean final serum creatinine was 0.9 and 1.7 mg/dL, respectively (P <.05). Persistent upper tract dilatation was noted in 43% of group 1 patients and in 69% of group 2 patients (P <.05). CONCLUSION:The potential for recovering renal function is believed to be significant in patients in whom early detection of PUVs and, hence, early intervention was performed. Antenatal screening and detection of these patients might play a significant role in protecting the upper tract and reducing the incidence of chronic kidney disease.

journal_name

Urology

journal_title

Urology

authors

Sarhan OM,Helmy TE,Alotay AA,Alghanbar MS,Nakshabandi ZM,Hafez AT

doi

10.1016/j.urology.2013.07.058

subject

Has Abstract

pub_date

2013-12-01 00:00:00

pages

1405-9

issue

6

eissn

0090-4295

issn

1527-9995

pii

S0090-4295(13)01116-3

journal_volume

82

pub_type

杂志文章,多中心研究

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