Related Experiment Video
Updated: Dec 7, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Risk Factors Associated with Chronic Kidney Disease in Infants With Posterior Urethral Valve: A Single Center Study
Hossein Amirzargar1, Elaheh Shahab2, SeyyedMohammad Ghahestani3
1Division of Pediatric Urology, Pediatric Center of Excellence, Tehran University of Medical Sci-ences, No 62, Dr. Gharib's street, Keshavarz Blvd, PO Box: 1419733151, Tehran, Iran. h_amirzargar@sina.tums.ac.ir.
Insights
Children with posterior urethral valve (PUV) undergoing valve ablation and bladder neck incision have a higher risk of chronic kidney disease if their initial serum creatinine is elevated. Other factors were not significant predictors.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Outcomes
Background:
- Posterior urethral valve (PUV) is a common congenital anomaly in male infants.
- Concurrent valve ablation and bladder neck incision is a treatment option for PUV with a prominent bladder neck.
- Evaluating long-term renal outcomes, specifically chronic kidney disease (CKD) risk factors, is crucial for these patients.
Purpose of the Study:
- To assess the risk factors for developing chronic kidney disease (CKD) in children treated with concurrent valve ablation and bladder neck incision for posterior urethral valve (PUV).
Main Methods:
- Retrospective review of medical records for 110 children younger than 18 years who underwent valve ablation and bladder neck incision for PUV.
- Data collected included demographics, presenting symptoms, laboratory values, and radiographic data.
- Primary outcome was CKD (stage 3 or higher); risk factors analyzed included preoperative vesicoureteral reflux, serum creatinine, age at diagnosis, and urinary diversion.
Main Results:
- Of 110 patients, 12 (10.9%) progressed to CKD over a mean follow-up of 3 years.
- The most common presentation was prenatal diagnosis (72.7%).
- Elevated preoperative serum creatinine (>1 mg/dL) was the only significant risk factor associated with CKD progression.
Conclusions:
- Initial serum creatinine >1 mg/dL is a probable indicator of renal impairment in children with PUV treated with valve ablation and bladder neck incision.
- Vesicoureteral reflux, age at diagnosis, presenting symptoms, and urinary diversion were not significant prognostic factors for CKD.
- Further randomized controlled trials are needed to confirm the impact of this combined surgical approach on renal outcomes.
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 symptoms, laboratory and radiographic data. Our primary outcome was chronic kidney disease defined 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 analyzed.
Results:
A total of 110 patients met our inclusion criteria. Median age at diagnosis was 10.4 months (range 14 days to 12 years). Prenatal diagnosis in 72.7% was the most common presentation. Mean follow-up duration was 3 years and 12(10.9%) patients progressed to chronic kidney disease. Preoperative serum creatinine greater than one 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 incision, initial creatinine value of greater than one mg/dL is more probably associated with renal impairment while; vesicoureteral reflux, age at diagnosis, presenting symptoms and adjuvant urinary 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.
More Related Videos
06:05Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
Published on: October 12, 2017
06:39Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
Published on: November 22, 2019
Related Concept Videos
01:27Acute Pyelonephritis I: Introduction
01:29Acute Kidney Injury II: Pathophysiology
01:26Kidney Transplant II: Surgical Procedure
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:19Mitral Valve Prolapse III: Nursing Management
01:20Disorders of the Urinary System
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...