Sarhan Osama M
Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Arab J Urol. 2017 Mar 7;15(2):159-165. doi: 10.1016/j.aju.2017.01.005. eCollection 2017 Jun.
To investigate the relationship between low birth weight (LBW; <2.5 kg) and preterm delivery (<37 weeks gestational age) and final renal outcome in infants with posterior urethral valves (PUVs), emphasising the risk factors for the development of chronic kidney disease (CKD).
A retrospective review was performed for all infants with PUVs who were treated between 1990 and 2010. In all, 52 infants were identified to have LBW and/or delivered preterm (Group 1). Infants in Group 1 were compared with a matching group (Group 2) of 60 full-term normal birth weight (NBW) infants with PUVs managed during the same period. The outcome of both groups was analysed.
During follow-up, CKD developed in 17 (32.5%) and 22 patients (36.5%) in Groups 1 and 2, respectively ( = 0.812). Patients with LBW or delivered preterm had significantly higher incidence of oligohydramnios ( = 0.009), increased risk of vesicostomy ( < 0.001), longer hospital stay ( < 0.001), and higher incidence of vesico-ureteric reflux (VUR, = 0.024). In the LBW patients, initial serum creatinine, nadir serum creatinine, oligohydramnios and Neonatal Intensive Care Unit (NICU) length of stay were significant predictors of final renal outcome ( < 0.001, = 0.002, = 0.004 and = 0.012, respectively).
In our cohort of LBW and preterm delivery infants with PUVs, outcomes were similar to those of NBW full-term infants with PUVs but with an increased risk of vesicostomy, longer hospital stay, and higher incidence of VUR. LBW was associated with oligohydramnios, longer NICU admission, high initial and nadir serum creatinine, which were associated with a poor prognosis.
探讨低出生体重（LBW；<2.5kg）和早产（胎龄<37周）与后尿道瓣膜症（PUV）患儿最终肾脏结局之间的关系，重点关注慢性肾脏病（CKD）发生的危险因素。
对1990年至2010年间接受治疗的所有PUV患儿进行回顾性研究。共确定52例低出生体重和/或早产的患儿（第1组）。将第1组患儿与同期治疗的60例足月正常出生体重（NBW）的PUV患儿匹配组（第2组）进行比较。分析两组的结局。
随访期间，第1组和第2组分别有17例（32.5%）和22例（36.5%）发生CKD（P = 0.812）。低出生体重或早产的患儿羊水过少发生率显著更高（P = 0.009），膀胱造瘘风险增加（P < 0.001），住院时间更长（P < 0.001），膀胱输尿管反流（VUR）发生率更高（P = 0.024）。在低出生体重患儿中，初始血清肌酐、最低血清肌酐、羊水过少和新生儿重症监护病房（NICU）住院时间是最终肾脏结局的显著预测因素（分别为P < 0.001、P = 0.002、P = 0.004和P = 0.012）。
在我们的低出生体重和早产的PUV患儿队列中，结局与足月正常出生体重的PUV患儿相似，但膀胱造瘘风险增加、住院时间更长、VUR发生率更高。低出生体重与羊水过少、NICU住院时间延长、初始和最低血清肌酐水平高有关，这些与预后不良相关。
