Department of Pediatric Urology, University of Health Sciences, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.
Department of Urology, University of Health Sciences, Sultan Abdülhamid Han Education and Research Hospital, Istanbul, Turkey.
Low Urin Tract Symptoms. 2020 Sep;12(3):274-277. doi: 10.1111/luts.12316. Epub 2020 May 19.
The aim of this retrospective study is to describe the importance of serum creatinine levels for the long-term renal outcome in cases of posterior urethral valve.
Records of 94 patients who underwent cystoscopic valve ablation were evaluated retrospectively. Demographic variables, radiologic findings, and serum creatinine levels were recorded. Patients were grouped according to the serum creatinine levels in the first month of life. Twenty-four patients' serum creatinine levels were found to be above 1 mg/dL in group 1 and ≤1 mg/dL in 70 patients in group 2.
The initial findings of 74 patients were as follows: pyelonephritis in 24 (32.43%) patients, hydronephrosis in 20 (27.02%), and inability to urinate in 18 (24.32%). Prenatal hydronephrosis was present in 36 cases (38.29%). Of the 92 voiding cystograms, 53.26% had findings that included vesicoureteral reflux. The mean serum creatinine levels of the patients in group 1 increased above 1 mg/dL in the 2nd year, the significant difference between the two groups lasted up to 7 years of age, and no significant difference was observed at the age of 7. The mean serum creatinine levels of the patients in group 2 were observed to increase above 1 mg/dL by the 10th year.
In patients with posterior urethral valves, nadir creatinine, especially higher than 1 mg/dL, should be considered as high risk for end-stage renal disease. Therefore, clinicians should improve awareness about early detection and treatment of posterior urethral valves, and these patients should be monitored as early as possible for the risk of chronic kidney disease.
本回顾性研究旨在描述血清肌酐水平在后尿道瓣膜病例中的重要性，以预测长期肾脏预后。
回顾性评估了 94 例行膀胱镜瓣膜消融术患者的记录。记录了人口统计学变量、影像学发现和血清肌酐水平。根据出生后第一个月的血清肌酐水平将患者分为两组。第 1 组 24 例患者的血清肌酐水平超过 1mg/dL，第 2 组 70 例患者的血清肌酐水平≤1mg/dL。
74 例患者的初始发现如下：24 例（32.43%）患者患有肾盂肾炎，20 例（27.02%）患者患有肾积水，18 例（24.32%）患者存在排尿困难。36 例（38.29%）患者存在产前肾积水。92 例排尿性膀胱造影中，53.26%存在膀胱输尿管反流。第 1 组患者的血清肌酐水平均值在第 2 年超过 1mg/dL，两组之间的显著差异持续至 7 岁，而在 7 岁时无显著差异。第 2 组患者的血清肌酐水平均值在第 10 年观察到超过 1mg/dL。
在后尿道瓣膜患者中，血清肌酐水平的最低点，特别是高于 1mg/dL，应被视为终末期肾病的高风险因素。因此，临床医生应提高对早期发现和治疗后尿道瓣膜的认识，应尽早对这些患者进行监测，以预防慢性肾脏病的发生。
