ESPN 50th Annual Meeting

ESPN 2017


 
FIVE YEAR RENAL OUTCOME IN PATIENTS WITH POSTERIOR URETHRAL VALVES
KATERINA PRODROMOU 1 RICCARDO MANUELE 1 KALPANA PATIL 1 ARASH TAGHIZADEH 1 MANISH SINHA 1 JO CLOTHIER 1 MASSIMO GARRIBOLI 1

1- EVELINA LONDON CHILDREN’S HOSPITAL
 
Introduction:

Posterior urethral valves (PUV) are a congenital anomaly causing obstructive uropathy. We describe our cohort, their presentation and the renal status at 5 year of age.

Material and methods:

We retrospectively reviewed the medical notes of all boys with PUV born from 2005 to 2011 and followed-up at our institution. We collected data on presentation and renal function at age 5 years. Values are shown as median (range). T test and Chi Square tests were used for statistical analysis

Results:

94 patients were identified, 44(46.8%) had an antenatal diagnosis. Those diagnosed postnatally had age at presentation 2 (0-106) months. 12 children presented at age >2 years. The most common postnatal presentation was sepsis and renal impairment in neonates and recurrent urinary tract infection in older children. Serum Creatinine at presentation was 140umol/L (20-515) in the prenatal group and 55 umol/L (20-557) in the postnatal (p=0.0034). Two patients (with multiple associated pathologies) died of reasons not related to PUV, at 1 and 3 years, respectively. The first patient died of severe sepsis and acute cerebral ischemia and the second patient of central nervous system vasculitis on the background of progressive steno-occlusive cerebrovascular disease. Estimated GFR at age 5 years was available for 75 patients. Before the age of 5 years, six patients had renal transplant and 1 was started on peritoneal dialysis. Renal function was worse in the group with prenatal diagnosis (p=0.056). Table shows the patients divided per their CKD stage I-V and V+RRT (Renal Replacement Therapy).

CKD

ANTENATAL

N=32

POST NATAL

N=50

TOTAL

N=82

I

8 (25%)

17(34%)

25(30%)

II

10(31%)

18(36%)

28(34%)

III

5(16%)

8(16%)

13(16%)

IV

3(9%)

2(4%)

5(6%)

V

2 (6%)

2(4%)

4(5%)

V + RRT

4(12.5%)

3(6%)

7 (8.5%)

 

 

 

 

 

Conclusions:

 In our cohort, the majority had normal or mildly reduced renal function at age of 5 years with worse renal function in those diagnosed prenatally perhaps reflecting more evident disease prenatally.