Related Experiment Videos
Prognostic factors in Saudi children with posterior urethral valves
V C Onuora1, K Mirza, A H Koko
1Department of Urology, Riyadh Medical Complex, Saudi Arabia. vconuora@deltasa.com
Insights
Posterior urethral valves (PUV) significantly impact children's renal function. Early serum creatinine levels after catheter drainage strongly predict long-term kidney outcomes in these patients.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Posterior urethral valves (PUV) are a common cause of chronic renal failure in children.
- Predictive criteria for renal function in PUV patients are crucial for management.
Purpose of the Study:
- To compare presenting features and initial treatments in Saudi children with PUV.
- To identify factors influencing renal function differences in PUV patients.
Main Methods:
- Retrospective comparison of two groups of Saudi children with PUV based on follow-up serum creatinine levels.
- Analysis of presenting features, reflux, UTIs, and primary treatment modalities.
- Correlation analysis between post-drainage creatinine and long-term renal function.
Main Results:
- No significant differences in age, weight, reflux, UTIs, or primary treatment between groups.
- Mean serum creatinine after 5-7 days of catheter drainage was significantly lower in the better renal function group (88+/-62 vs 172+/-77 micromol/l, P<0.0001).
- Post-drainage creatinine strongly correlated with serum creatinine at last follow-up (r=0.7171, P<0.0001).
Conclusions:
- Serum creatinine levels after initial catheter drainage are a strong predictor of short-term renal function in Saudi children with PUV.
- This finding may aid in selecting optimal initial therapy and prognostication for PUV patients.
Abstract:
Posterior urethral valves (PUV) account for a sizeable proportion of children with chronic renal failure. Several criteria have been identified as predictive of future renal function in children with PUV. We compared the presenting features and initial treatment in two groups of Saudi children treated for PUV, with the aim of identifying any factors that might account for the differences observed in their renal function. One group (group A, 19 patients) had a serum creatinine of 80 micromol/l or less at follow-up and the other (group B, 13 patients) had higher levels. There was no significant difference in age or weight at presentation, incidence and severity of reflux, urinary tract infection, or type of primary treatment (valve ablation versus vesicostomy) between the two groups. However, after 5-7 days of catheter drainage, the mean serum creatinine level was 88+/-62 micromol/l for patients in group A compared with 172+/-77 micromol/l for those in group B (P<0.0001). This difference was highly significant. Linear regression analysis of post-drainage creatinine and serum creatinine at last follow-up showed a correlation coefficient of 0.7171 (P<0.0001). Hence the serum creatinine level after catheter drainage correlated strongly with renal function during short-term follow-up of Saudi children with PUV. This might help in the selection of the optimal initial therapy and provide some basis for prognostication.