The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
Department of Urology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, 362000, China.
Pediatr Surg Int. 2022 Sep;38(9):1321-1326. doi: 10.1007/s00383-022-05154-7. Epub 2022 Jul 2.
To analyze the mid-short-term risk factors for chronic renal failure (CRF) in children with posterior urethral valve (PUV) after valve ablation.
A retrospective study of 143 patients with PUV who underwent operation was performed. Patients were divided into CRF group (n = 39) and non-CRF group (n = 104). Clinical data of both groups such as the first resection age, last resection age, number of operations, the maximal detrusor pressure (Pdet), and vesicoureteral reflux (VUR) were collected and analyzed.
The first resection age, last resection age, and the Pdet of patients in the CRF group were higher than those of patients in the non-CRF group (P < 0.05). Multiple regression analysis showed that the indicators related to chronic renal failure were last resection age (β = 1.034, P < 0.05) and Pdet (β = 1.068, P < 0.05). The cut-off value of last resection age was 35.5 months, Pdet was 41.65 cmHO. There was positive correlation of final blood creatinine with last resection age and Pdet.
The last resection age and Pdet are the risk factors of chronic renal failure in children with PUV. A Pdet of lower than 41.65 cmHO indicates a good prognosis of renal function in patients with PUV.
分析后尿道瓣膜（PUV）患儿瓣膜切除术后发生慢性肾衰竭（CRF）的中短期危险因素。
回顾性分析 143 例接受手术治疗的 PUV 患儿的临床资料，根据术后是否发生 CRF 将患儿分为 CRF 组（n=39）和非 CRF 组（n=104）。收集并比较两组患儿的首次手术年龄、末次手术年龄、手术次数、最大逼尿肌压力（Pdet）、上尿路反流（VUR）等临床资料。
CRF 组患儿的首次手术年龄、末次手术年龄及 Pdet 均高于非 CRF 组（P<0.05）。多因素回归分析显示，与 CRF 发生相关的指标为末次手术年龄（β=1.034，P<0.05）和 Pdet（β=1.068，P<0.05）。末次手术年龄的截断值为 35.5 个月，Pdet 的截断值为 41.65cmH2O。最终血肌酐与末次手术年龄、Pdet 呈正相关。
末次手术年龄和 Pdet 是 PUV 患儿发生 CRF 的危险因素，Pdet<41.65cmH2O 提示 PUV 患儿的肾功能预后较好。
