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- Title
POSTERIOR URETHRAL VALVE, PARTE OF CONGENITAL OBSTRUCTIVE UROPATHIES; PROGNOSTIC FACTORS IN LONG TERM FOLLOW UP.
- Authors
Bogos, Roxana Alexandra; Russu, Radu; Stârcea, Iuliana Magdalena; Munteanu, Mihaela; Mocanu, Maria Adriana; Nedelcu, Doina; Ciongradi, Iulia; Sârbu, Ioan; Scurtu, Georgiana; Alecsa, Mirabela Smaranda; Miron, Ingrith Crenguța; BărbuȚă, Ovidiu Ionel
- Abstract
Background: The posterior urethral valve (PUV) is an important cause of lower urinary tract obstruction in boys, with a wide spectrum of presentations, different degrees of severity, and in 25-45% of patients end with stage kidney failure. Objective: Monitoring the children diagnosed and operated for PUV and identifying the predictive factors for the evolution towards chronic kidney failure. Material and method: Retrospective analysis of children treated for PUV at Children' Hospital "St. Mary" Iasi during 2004-2014. We followed: age, clinical presentation, recurrences of urinary tract infection (UTI), association with/without vesicoureteral reflux (VUR), serum creatinine levels (at diagnosis, after valve resection and at the end of follow-up) and correlation with the degree of impaired of renal function over time. Results. Of the 18 boys diagnosed between 2 days and 12 years old; 11 were admitted for recurrent UTI, and 5 were presented for the investigation after antenatal diagnosis of hydronephrosis.11 cases presented grade IV and V VUR, bilateral in 6 cases. Impairment of renal function was present at initial diagnosis in all patients in various degrees and at the end of follow-up period 5 patients were with end stage kidney disease with creatinine clearance less than 60 ml/min/1.73 sqm. Two of them were in end stage of renal insufficiency under dialysis and one in the predialytic stage. Unfavorable prognostic factors were late diagnosis with recurrent UTI, association with VUR, and persistent increased creatinine after valve resection. Conclusion. The study reveals the persistence of recurrent urinary tract infection as the main criteria to identify the posterior urethral valve (11/19). Late diagnosis along with the persistence of increased creatinine after valve resection were the main factors of unfavorable prognosis of renal function.
- Subjects
VESICO-ureteral reflux; PROGNOSIS; URINARY tract infections; CHRONIC kidney failure; VALVES; DELAYED diagnosis
- Publication
Jurnalul Pediatrului, 2021, Vol 24, Issue 93/94, p8
- ISSN
2360-4557
- Publication type
Article
- DOI
10.37224/JP.2021.9394.02