Nadir creatinine predicts long-term bladder function in boys with posterior urethral valves

Area of Science:

• Pediatric Urology
• Renal Physiology
• Developmental Biology

Background:

• Posterior urethral valves (PUV) cause lower urinary tract obstruction, impacting fetal urinary tract development.
• Bladder and kidney function are interconnected, influencing each other prenatally and postnatally.

Purpose of the Study:

• To assess the relationship between renal and bladder function in boys with PUV.
• To determine if early renal markers can predict future bladder function in these patients.

Main Methods:

• Retrospective study of boys with prenatally suspected lower urinary tract obstruction (2000-2013).
• Inclusion criteria: PUV diagnosis, ≥5 years follow-up, exclusion of other defects/neonatal deaths.
• Data collected: nadir creatinine (NC), long-term renal function, and bladder function (Uroflow parameters).

Main Results:

• 73 boys included; average nadir creatinine 43.4 ± 26.1 μmol/L.
• Nadir creatinine levels significantly correlated with bladder function at 5 years.
• Higher NC levels were associated with an increased risk of severe bladder dysfunction and impaired renal function (CKD).

Conclusions:

• Renal and bladder function are closely linked in boys with posterior urethral valves.
• Nadir creatinine is a valuable early marker for predicting bladder dysfunction.
• Boys with high nadir creatinine may benefit from early and aggressive bladder function evaluation and management.