Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
J Pediatr Urol. 2010 Feb;6(1):11-4. doi: 10.1016/j.jpurol.2009.05.016. Epub 2009 Jul 5.
We evaluated the prognostic value of serum creatinine level at presentation and nadir creatinine during follow up for future renal function (RF) in children with posterior urethral valves (PUV).
Between 1987 and 2004, 120 cases of PUV were treated initially at our hospital with valve ablation. Initial assessment included serum creatinine measurement, urine analysis and culture, renal ultrasonography and voiding cystourethrography. After valve ablation, renal ultrasound and serum creatinine measurement were repeated and thereafter during visits until the end of follow up.
Follow up ranged from 2 to 12 years (mean=4.4). Renal insufficiency (RI) developed at the end of follow up in 44 patients (36.5%). The mean initial and nadir serum creatinine in the RI group was higher than in the normal RF group (P<0.05). With a cut-off value of 1mg/dl for initial and nadir serum creatinine, the incidence of RI was significantly different (P<0.05).
Our data confirm the high prognostic value of nadir serum creatinine after relief of valvular obstruction. Further, the serum creatinine level before valve ablation correlates significantly with long-term RF in children with PUV.
我们评估了在患有后尿道瓣膜（PUV）的儿童中，就诊时血清肌酐水平和随访期间的最低肌酐值对未来肾功能（RF）的预后价值。
1987 年至 2004 年期间，我们医院对 120 例 PUV 患儿进行了初始瓣膜消融治疗。初始评估包括血清肌酐测量、尿液分析和培养、肾脏超声和排尿性膀胱尿道造影。瓣膜消融后，重复进行肾脏超声和血清肌酐测量，此后在就诊期间直至随访结束。
随访时间为 2 至 12 年（平均 4.4 年）。44 例患儿（36.5%）在随访结束时出现肾功能不全（RI）。RI 组的初始和最低血清肌酐均值高于正常 RF 组（P<0.05）。以初始和最低血清肌酐值为 1mg/dl 为截断值，RI 的发生率存在显著差异（P<0.05）。
我们的数据证实了瓣膜梗阻解除后最低血清肌酐值具有很高的预后价值。此外，在患有 PUV 的儿童中，瓣膜消融前的血清肌酐水平与长期 RF 显著相关。
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