Posterior urethral valves: prognostic factors

Pereira, P. López; Espinosa, Laura; Urrutina, M.J. Martinez; Lobato, Roberto; Navarro, Mercedes; Jaureguízar, E

doi:10.1046/j.1464-410x.2003.04178.x

Cited by 85 publications

(57 citation statements)

References 17 publications

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“…The associated obstructive nephropathy and renal dysplasia are the leading cause of ESRD in surviving children (2). Approximately 20%-30% of affected children progress to ESRD in the first decade of life, and the majority progress to CKD (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Urinary Biomarkers in Obstructive Nephropathy

Trnka

Ivanova

Hiatt

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Obstructive nephropathy is a leading cause of CKD in children. The assessment of severity of renal impairment and the prediction of which children will progress to renal failure are, however, challenging.Design, Setting, Participants, & Measurements This case-control study measured the urinary excretion of candidate biomarkers in 27 prevalent case-patients with posterior urethral valves (PUVs) and 20 age-matched controls, correlated their urinary concentration with GFR, and analyzed receiver-operating characteristic (ROC) curve and regression analyses to assess their performance as tests for low GFR.Results The median urinary protein-to-creatinine ratio was higher in children with PUV (45 g/mol; range, 5-361 g/mol) than in controls (7 g/mol; range, 3-43 g/mol) (P,0.01) and correlated inversely with renal function (r = 20.44; P,0.05). In whole urine, excretion of aquaporin-2 was significantly decreased, whereas that of TGFb and L1 cell adhesion molecule (L1CAM) was significantly increased. Whole-urine TGFb excretion correlated inversely with GFR (r = 20.53; P,0.05). As tests for low GFR, whole-urine TGFb, L1CAM, and urinary proteinto-creatinine ratio performed best, with areas under the ROC curves of 0.788, 0.795, and 0.814, respectively. By linear regression analysis, whole-urine TGFb, L1CAM, and urinary protein-to-creatinine ratio were associated with low GFR in the case-patients.Conclusions Candidate biomarkers of obstructive nephropathy can be readily measured in whole urine and in urine exosomes. In boys with PUV, these biomarkers correlate with GFR.

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Section: Introductionmentioning

confidence: 99%

Urinary Biomarkers in Obstructive Nephropathy

Trnka

Ivanova

Hiatt

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…7,32 CKD. 22,23 In 2003, Osama demonstrated that when the clearance of creatinine was lower than 60 mL/min/1.73 m 2 , the prognosis for renal failure in the future would be at approximately 50%, while for creatinine clearance above 90 mL/min/1.73 m 2 , the incidence of renal failure would decrease to 27%. 17 Some other factors are also considered in assessing the risk of developing CKD in the future or its progression to ESRD.…”

Section: Voiding Cystourethrographymentioning

confidence: 99%

Valve bladder syndrome in children: On the trail of the best strategies to prevent chronic kidney disease

Polak−Jonkisz¹,

Rehan²,

Fornalczyk³

et al. 2017

Adv Clin Exp Med

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Pediatric patients suffering from valve bladder syndrome (VBS) are at risk of developing chronic kidney disease (CKD) and renal failure in later life. Therefore, it is of vital importance to determine the risk factors and the best possible strategies for diagnosis and treatment in patients with VBS that would minimize the risk of developing CKD. In this review we have presented the current knowledge of CKD risk factors in patients with posterior urethal value (PUV). We have also discussed possible recommendations for prenatal diagnostics procedures to be undertaken in patients with PUV, postnatal monitoring and therapeutic strategies that could reduce the risk of developing CKD in this population. Although in most cases there are no clear guidelines for appropriate clinical actions that can be undertaken in patients with PUV to minimize the risk of kidney failure, we have tried to present concise and accurate advice for physicians taking care of patients with PUV.

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“…3,7,8 Floroskopi altında yapılan VCUG, PUV ve VUR şüphesi olan hastalarda en sık başvurulan ve altın standart olan bir tetkiktir; fakat suprapubik veya üretral yolla mesane kateterizasyonu gerektiren bir tetkik olduğu için invaziv ve ağrılıdır. 12,13 Mesane kateterizasyonunu takiben seyreltilmiş radyoopak sıvı 40-70 cmH 2 O basıncı ile mesaneye verilir. Hastadan mesane dolumu esnasında ve üretra kateteri çıkarıldıktan sonra işeme esnasında radyografik görüntüler alınır.…”

Section: Bulgularunclassified

“…Literatürle kıyaslandığında VUR görülme sıklığının benzer olduğu görüldü. [7][8][9][13][14][15] VUR görülmeyen 14 (%35) olguda posterior üretra dilatasyonu mevcut olup, aynı zamanda mesane kapasitesi artmıştı.Prenatal tanı yapılmış olmasına rağmen dört hastamız doğumdan sonra erken dönemde takibe gelmemişti. İki hastamızda ise erken dönem takiplerinde vezikostomi açılmasına rağmen iki yaşla-rında PUV gösterilememesi nedeni ile vezikostomileri kapatılmıştı.…”

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Importance of the Vesicoureteral Reflux in the Diagnosis of Posterior Urethral Valve

Celayir¹,

Moralıoğlu²,

Bosnalı³

et al. 2015

Turkiye Klinikleri J Med Sci

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Hastaların 31'inde prenatal tanı mevcuttu. Prenatal ultrasonografide hidronefroz veya hidroüreteronefroz saptanan hastaların 21'inde tipik posterior üretra dilatasyonu da mevcuttu. Kırk hastanın ilk VCUG'leri değerlendirildiğinde; 31 (%77,5)'inde işeme esnasında posterior üretrada dilatasyon saptanırken, 9 (%22,5) hastada işeme esnasında üretra görüntülenemedi, ancak bu hastalarda bilateral VUR mevcuttu. Kırk hastanın 19 (%47,5)'unda iki taraflı, 7 (%17,5)'sinde tek taraflı olmak üzere toplamda 26 (%65) hastada Grade V VUR mevcuttu, toplam 45 (%56,3) renal ünite VUR'den etkilenmişti. S So on nu uç ç: : PUV açısından klinik olarak şüpheli olgularda, VCUG'de posterior üretranın görüntülenemediği durumlarda, özellikle tek veya çift taraflı VUR olması hâlinde PUV'yi dışlamak için sistoskopi yapılması esastır.A An na ah h t ta ar r K Ke e l li i m me e l le er r: : Üretra tıkanıklığı; vezikoüreteral reflü A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Voiding cystourethrography (VCUG) is the gold standard in the diagnosis of the posterior urethral valve (PUV). This study was planned to show the importance of the presence of vesicoureteral reflux (VUR) in the diagnosis of PUV. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : Hospital records of the patients with the PUV that were hospitalized and followed in our department between January 2004 and July 2013 were examined retrospectively and first VCUGs of their were analyzed. R Re es su ul lt ts s: : During the 9.5 years period, 40 patients with PUV interned and treated at our department; 31 patients were admitted under the one year of age. Thirty one cases had a prenatal diagnosis. There were typical images of the posterior urethral dilatation in 21 cases in the antenatal ultrasound. The first VCUGs of these 40 cases were evaluated retrospectively; the typical posterior urethral dilatation in micturition were determined in VCUGs of 31 (77.5%) cases; but any urethral image on micturition could be obtained in other patients (22.5%); but there were bilateral VUR in these 9 cases. Totally, grade V VUR were seen in 26 (65%) patients; 19 (47.5%) of them had bilateral VUR, and 7 (17.5%) of them had unilateral. Fourty five (56.3%) renal units were affected with VUR. C Co on nc cl lu us si io on n: : In the case of clinical suspicion of PUV, in the presence of unilateral or bilateral VUR in the case of lack of imaging of posterior urethra in the VCUG, exclusion of PUV should be made by cystoscopy. Obstrüksiyonun derecesi ve süresi böbrek hasarını belirler, böbrek ve mesane fonksiyonunda geriye dönüşümlü veya dönüşümsüz patolojilerin gelişmesine neden olur.1-7 PUV hastalarında prognozu esas olarak, renal hasarlanmanın derecesi belirlemektedir.7-9 Renal hasarlanma ya renal displazi nedeni ile doğumsal ve geri dönüşümsüzdür; ya da valve sekonder gelişen obstrüktif üropati ve vezikoüreteral reflü (VUR) nedeni iledir. Bunlarda, erken tanı, uygun cerrahi ve medikal tedavi ile sıvı elektrolit düzensizliğinde ve idrarla sodyum kaybında potansiyel olarak kısmen ge...

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Posterior urethral valves: prognostic factors

Cited by 85 publications

References 17 publications

Urinary Biomarkers in Obstructive Nephropathy

Urinary Biomarkers in Obstructive Nephropathy

Valve bladder syndrome in children: On the trail of the best strategies to prevent chronic kidney disease

Importance of the Vesicoureteral Reflux in the Diagnosis of Posterior Urethral Valve

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