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Risk Factors Associated With Chronic Kidney Disease in Infants With Posterior Urethral Valve: A Single Center Study of 110 Patients Managed by Valve Ablation and Bladder Neck Incision Publisher Pubmed



Amirzargar H1 ; Shahab E2 ; Ghahestani SM1 ; Hekmati P1 ; Arshadi H1
Authors
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Authors Affiliations
  1. 1. Division of Pediatric Urology, Pediatric Center of Excellence, Tehran University of Medical Sciences, No 62, Dr. Gharib’s street, Keshavarz Blvd, PO Box: 1419733151, Tehran, Iran
  2. 2. Department of surgery, Kosar general hospital, Semnan University of Medical Sciences, Go-lestan Blvd, PO Box: 3519899558, Semnan, Iran

Source: Urology Journal Published:2021


Abstract

Purpose: Concurrent valve ablation and bladder neck incision is suggested as an effective and safe treatment approach in posterior urethral valve children with prominent bladder neck. We evaluated chronic kidney disease risk factors in these children. Materials and methods: We retrospectively reviewed medical records of children with posterior urethral valve and included those younger than 18 years old who underwent valve ablation and bladder neck incision at our institution. We recorded patient demographics, presenting symp-toms, laboratory and radiographic data. Our primary outcome was chronic kidney disease de-fined as stage 3 chronic kidney disease or higher. Renal outcome risk factors such as preoperative vesicoureteral reflux and serum creatinine, age at diagnosis, adjuvant urinary diversion were ana-lyzed. Results: A total of 110 patients met our inclusion criteria. The median age at diagnosis was 10.4 months (range 14 days to 12 years). Prenatal diagnosis in 72.7% was the most common presenta-tion. Mean follow-up duration was 3 years and 12 (10.9%) patients progressed to chronic kidney disease. Preoperative serum creatinine greater than 1 mg/dL was the only factor associated with progression to chronic kidney disease. Conclusion: In our group of children with posterior urethral valve ablation and bladder neck in-cision, initial creatinine value of greater than 1 mg/dL is more probably associated with renal im-pairment while; vesicoureteral reflux, age at diagnosis, presenting symptoms, and adjuvant uri-nary diversion were not significant prognostic factors. Further randomized controlled evaluations are required to analyze the effects of concurrent valve ablation and bladder neck incision on renal outcome. © 2021. Urology Journal.All Rights Reserved
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2. Long-Term Impacts of Concurrent Posterior Urethral Valve Ablation and Bladder Neck Incision on Urinary Continence and Ejaculation, Urology (2017)
3. Commentary to Effect of Botox Injection at the Bladder Neck in Boys With Bladder Dysfunction After Valve Ablation, Journal of Pediatric Urology (2015)
4. The Effect of Urinary Diversion on Kidney Function in Posterior Urethral Valves and Ureterovesical Obstruction, International Urology and Nephrology (2025)
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