Renal outcomes of children born with posterior urethral valves at a tertiary center: A 15-year retrospective review

Authors

  • Alexandra Bain University of Alberta
  • Callum Lavoie Division of Urology, University of Alberta Hospita
  • Sara Rodriguez Lopez Division of Pediatric Nephrology, Stollery Children's Hospital, Edmonton
  • Darcie Kiddoo Division of Pediatric Urology, Stollery Children's Hospital, Edmonton

DOI:

https://doi.org/10.5489/cuaj.8102

Keywords:

posterior urethral valves, end stage renal disease, pediatric urology

Abstract

INTRODUCTION: Posterior urethral valves (PUVs) is a congenital condition in which an obstruction in the urethra prevents drainage of urine from the bladder in males, with up to 60% of children diagnosed developing chronic kidney disease (CKD). The primary aim of this study was to identify novel factors that may predict development of CKD and end-stage real disease (ESRD) in children with PUVs to potentially address modifiable factors and delay progression. The secondary aim was to compare rates of catheterization and incontinence between our patients and other case series to provide information to parents about longterm bladder outcomes.

METHODS: A single-center, retrospective cohort study was performed of all children referred to our multidisciplinary clinic for PUV diagnosis between 2005 and 2019. Univariable associations of different variables with the composite outcome CKD or ESRD were evaluated.

RESULTS: Thirty of 46 patients (65%) developed CKD, with the majority (40%) being stage 2 CKD (n=12). Seven of 30 patients (23%) developed ESRD requiring renal replacement therapy. Fourteen of 26 (30%) required clean intermittent catheterization (CIC) initiation, with a median CIC initiation age of 4.3 years. Creatinine nadir post-valve ablation, oligohydramnios, and initiation of CIC are significant predictors of CKD development.

CONCLUSIONS: This review reiterates that children born with PUVs have a high morbidity rate, with a high proportion developing CKD. Using a multidisciplinary approach to PUV patient care allows for better family education, early intervention of bladder dysfunction, and possibly better long-term preservation of renal function.

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Published

2022-12-06

How to Cite

Bain, A. ., Lavoie , C. ., Rodriguez-Lopez, S. ., & Kiddoo, D. . (2022). Renal outcomes of children born with posterior urethral valves at a tertiary center: A 15-year retrospective review. Canadian Urological Association Journal, 17(4), 111–6. https://doi.org/10.5489/cuaj.8102

Issue

Vol. 17 No. 4 (2023): CUAJ April

Section

Original Research

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