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Posterior urethral valves: long-term renal function consequences after transplantation
L Salomon1, E Fontaine, M F Gagnadoux
1Department of Urology, Ambroise Paré Hospital, University of West Paris, Boulogne, France.
Insights
Renal transplantation is effective for children with posterior urethral valves, showing similar graft survival to controls. Long-term graft function decline may relate to lower urinary tract issues.
Area of Science:
- Pediatric Nephrology
- Urology
- Transplantation Immunology
Background:
- Posterior urethral valves (PUV) are a common cause of congenital lower urinary tract obstruction in male infants.
- Kidney transplantation is a life-saving option for children with end-stage renal disease due to PUV.
- Long-term outcomes of renal transplantation in children with PUV require further evaluation.
Purpose of the Study:
- To assess the long-term efficacy and graft survival of renal transplantation in pediatric patients with posterior urethral valves.
- To compare outcomes between children with PUV and a control group with other malformation uropathies.
Main Methods:
- Retrospective cohort study comparing 66 children with PUV to 116 control patients.
- Analysis of graft survival rates at 5 and 10 years post-transplantation.
- Evaluation of serum creatinine levels as an indicator of long-term graft function.
Main Results:
- Graft survival rates at 5 years were 69% for PUV and 72% for controls; at 10 years, 54% for PUV and 50% for controls (not statistically significant).
- A statistically significant increase in serum creatinine was observed at 10 years in the PUV group, indicating graft function deterioration.
- No significant increase in serum creatinine was noted in the control group.
Conclusions:
- Renal transplantation in children with posterior urethral valves demonstrates comparable long-term graft survival to other uropathies.
- Deterioration of graft function over time in PUV patients is likely associated with underlying lower urinary tract dysfunction.
- Further management strategies should consider the impact of lower urinary tract issues on transplanted kidney function.
Purpose:
We assessed the long-term efficacy of renal transplantation in children with posterior urethral valves.
Materials And Methods:
We retrospectively compared the outcomes of renal transplantation in 66 children with posterior urethral valves and 116 with malformation uropathies (controls).
Results:
Graft survival in the posterior urethral valves and control groups was 69 and 72% at 5 years, and 54 and 50% at 10 years, respectively (not statistically significant). A statistically significant increase in serum creatinine was noted at 10 years in children with posterior urethral valves but not in controls (p < 0.05).
Conclusions:
Renal transplantation in children with posterior urethral valves is not associated with a high rate of failure. However, long-term deterioration of graft function is likely related to lower urinary tract dysfunction.