Obstructive Nephropathy in Children: Long-Term Progression After Relief of Posterior Urethral Valve

Abstract

To test the effect of a therapeutic intervention to ameliorate the rate of progression, this steady and prolonged progression of 0.5 mg/dL per year between serum creatinine concentration of 1.5 to 5 mg/dL would seem the optimal study.

GYY4137, a Slow-Releasing Hydrogen Sulfide Donor, Ameliorates Renal Damage Associated with Chronic Obstructive Uropathy

“…If left untreated, it can lead to inflammation, atrophy, fibrosis, and irreversible renal injury ending in chronic kidney disease 2 , which can significantly burden both patients and the health care system 3 .…”

Congenital Obstructive Nephropathy: Clinical Perspectives and Animal Models

“…Male mgb-/-mice can be rescued from the complications of renal failure and early demise by cutaneous vesicostomy, but of the vesicostomized animals that survive the perioperative period, approximately 40% die within the first two weeks despite a patent stoma and no apparent surgical complications. This result is reminiscent of the fact that 27% to 70% of children with PUV will have progressive CKD despite surgery (Ansari, et al, 2010;Kousidis, et al, 2008;Parkhouse, et al, 1988;Roth, et al, 2001;Sanna-Cherchi, et al, 2009). Finally, mgb-/-mice possess no extrarenal features to complicate their utilization as a functional model of congenital obstructive nephropathy.…”

“…The profound changes that can result are outlined in Figure 6. As many as 70% of boys with PUV develop advanced chronic or end-stage kidney disease (CKD Stage 3-5; Parkhouse et al, 1988;Reinberg et al, 1992;Roth et al, 2001;Sanna-Cherchi, et al, 2009). Those with ultrasound findings at or before 24 weeks' gestation are significantly more likely to have a poor renal outcome than children with PUV detected later in pregnancy after a normal second trimester scan (Hutton, et al, 1994).…”

“…Many patients with congenital obstructive nephropathy, including the majority of patients with PUV, do not have complete recovery of kidney function following postnatal intervention (Parkhouse, et al, 1988;Reinberg, et al, 1992;Roth, et al, 2001;Sanna-Cherchi, et al, 2009). …”

Obstructive Uropathy in Children – An Update

“…Approximately 5-64% of these patient experience ESRD during childhood or adolescence. 8 Valves are tissue leaflets fanning distally from the prostatic urethra to the external urinary sphincter 5 . Posterior urethral valves (PUV) are of 3 types.…”