L Díaz Menéndez, I Casal Beloy, S Roldán Pérez, R M Romero Ruiz
{"title":"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。","authors":"L Díaz Menéndez, I Casal Beloy, S Roldán Pérez, R M Romero Ruiz","doi":"10.54847/cp.2024.04.14","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>In PUV children, renal functional reserve at birth is the only ESCRD risk predictor. Early clinical onset implies a higher risk of RRT.</p>","PeriodicalId":94306,"journal":{"name":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Posterior urethral valves: risk factors of progression to end-stage chronic renal disease after 10 years of follow-up.\",\"authors\":\"L Díaz Menéndez, I Casal Beloy, S Roldán Pérez, R M Romero Ruiz\",\"doi\":\"10.54847/cp.2024.04.14\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>In PUV children, renal functional reserve at birth is the only ESCRD risk predictor. Early clinical onset implies a higher risk of RRT.</p>\",\"PeriodicalId\":94306,\"journal\":{\"name\":\"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-10-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.54847/cp.2024.04.14\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cirugia pediatrica : organo oficial de la Sociedad Espanola de Cirugia Pediatrica","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.54847/cp.2024.04.14","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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.