后尿道瓣膜:10 年随访后发展为终末期慢性肾病的风险因素。

L Díaz Menéndez, I Casal Beloy, S Roldán Pérez, R M Romero Ruiz
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引用次数: 0

摘要

目的确定后尿道瓣膜(PUV)患者进展为终末期慢性肾病(ESCRD)的风险因素(RF)以及肾脏替代疗法(RRT)的需求:对 1995-2023 年期间确诊的 PUV 患者进行了病例和对照回顾性研究。设立了两个研究组--RRT 组与无 RRT 组。研究人员收集了临床、实验室和放射学变量。通过双变量分析和二元逻辑回归来检测是否需要 RRT:共纳入 127 名患者,其中 12.% 接受过 RRT(20 人)。平均随访时间为 9.87 年。RRT组的临床发病平均年龄较小(3个月对1.23岁;P= 0.010)。病理产前超声波检查(p< 0.001)、纳底血肌酐水平升高(p< 0.001)和出生后第一年的最高血肌酐水平(p结论:在 PUV 儿童中,出生时的肾功能储备是预测 ESCRD 风险的唯一指标。早期临床发病意味着接受 RRT 的风险更高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Posterior urethral valves: risk factors of progression to end-stage chronic renal disease after 10 years of follow-up.

Objective: To determine risk factors (RF) of progression to end-stage chronic renal disease (ESCRD) and the need for renal replacement therapy (RRT) in patients with posterior urethral valve (PUV).

Materials and methods: A retrospective case and control study of patients diagnosed with PUV in the 1995-2023 period was carried out. Two study groups were created -RRT vs. no-RRT. Clinical, laboratory, and radiological variables were collected. A bivariate analysis and a binary logistic regression were conducted to detect RFs of the need for RRT.

Results: 127 patients were included, 12.% of whom had undergone RRT (n= 20). Mean follow-up was 9.87 years. Mean age at clinical onset was younger in the RRT group (3 months vs. 1.23 years; p= 0.010). Pathological prenatal ultrasonography (p< 0.001), increased Nadir creatinine levels (p< 0.001) and maximum creatinine levels in the first year of life (p<  0.001), and onset with acute renal insufficiency (p= 0.03) were more frequent in the RRT group. Increased creatinine levels in the first week of life (OR: 4.74) and younger age at clinical onset (OR: 1.2) were the only independent RFs to predict the need for RRT. Diagnostic-therapeutic delay and the presence of UTIs during follow-up are not predictive of the risk of final RRT.

Conclusions: In PUV children, renal functional reserve at birth is the only ESCRD risk predictor. Early clinical onset implies a higher risk of RRT.

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