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Related Experiment Videos

Posterior urethral valves: prognostic factors.

P Lopez Pereira1, L Espinosa, M J Martinez Urrutina

  • 1Department of Paediatric Urology, University Hospital La Paz, Madrid, Spain. plpuro@hotmail.com

BJU International
|April 18, 2003
PubMed
Summary

Glomerular filtrate rate (GFR) at one year old is the key predictor of chronic renal failure (CRF) in boys with posterior urethral valves (PUV). Proteinuria and echogenic renal changes also indicate a worse prognosis for renal function.

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Area of Science:

  • Pediatric Nephrology
  • Urology
  • Medical Research

Background:

  • Posterior urethral valves (PUV) are a common congenital anomaly in male infants.
  • Bladder dysfunction is a known factor affecting renal function in PUV patients.
  • Predicting long-term renal outcomes beyond bladder issues is crucial for management.

Purpose of the Study:

  • To identify predictors of renal function outcome in boys with PUV, excluding bladder dysfunction.
  • To investigate the role of variables like vesico-ureteric reflux, urinary tract infections, and renal echogenicity.

Main Methods:

  • Retrospective study of 40 boys with PUV diagnosed within the first three months of life.
  • Minimum of five years of follow-up for all patients.
  • Comparison of initial and follow-up renal function, vesico-ureteric reflux, urinary tract infection, proteinuria, hypertension, renal echogenicity, and management strategies.

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Main Results:

  • Glomerular filtrate rate (GFR) at one year old was significantly lower in boys who developed chronic renal failure (CRF) (52 mL/min/1.73 m2) compared to those with normal renal function (102 mL/min/1.73 m2).
  • Proteinuria during follow-up was present in 79% of patients with CRF versus 17% with normal renal function.
  • Echogenic renal changes were observed in all patients who developed CRF, compared to 53% of those with normal renal function.

Conclusions:

  • GFR at one year old is the most significant predictor of future CRF in boys with PUV.
  • Onset of proteinuria during follow-up is associated with a poorer renal prognosis.
  • Renal echogenicity can help identify kidneys at risk for developing renal insufficiency.