Chronic Kidney Disease Prevalence and Risk Factors for Children with Posterior Urethral Valve: A Single-Center Experience

Purpose The aim of this study is to determine the prevalence of CKD in children with PUV and to identify risk factors associated with progression to CKD. Methods A total of 52 boys followed with a diagnosis of posterior urethral valves were retrospectively evaluated. Clinical and laboratory data (serum creatinine levels and glomerular filtration rate, ultrasonographic findings, urodynamic study results, DMSA findings, and voiding cystourethrography results) were recorded. Results The mean age of the 52 patients was 9.8±4.8 years, and the mean age at diagnosis was 28±41 months. Antenatal diagnosis was present in 32 patients (64%) and, CKD developed in 10 patients (%19.2). There was no significant difference in antenatal diagnosis rates between patients with and without CKD. In the non-CKD group, hydronephrosis grades decreased significantly at the last follow-up compared with baseline, whereas no significant improvement was observed in the CKD group, these patients had more severe and persistent hydronephrosis at final evaluation. Patients with CKD had higher ratios of increased bladder wall thickness and renal echogenicity at baseline and ureteral dilatation at final follow-up. There was no significant difference between groups regarding severe bladder dysfunction, DMSA renal scarring, vesicoureteral reflux grades, recurrent urinary tract infections, or incontinence. Conclusion Our findings suggest that renal damage in children with PUVs predominantly develops during the antenatal period. Children presenting with persistent hydronephrosis and elevated serum creatinine levels at initial admission were at higher risk of developing CKD.