title: Did antenatal diagnosis protect against chronic kidney disease in patients with posterior urethral valves? A multicenter study.
abstract: OBJECTIVE
  To evaluate the prognostic role of antenatal diagnosis of posterior urethral valves (PUVs) on ultimate renal function.
  
  
  METHODS
  Between 1990 and 2010, 315 patients with PUVs were diagnosed and treated at 2 separate tertiary centers. Primary valve ablation was performed in all patients except 18, who underwent initial vesicostomy. Patients were divided into two groups: group 1 included 144 patients who were diagnosed antenatally, and group 2 included 171 patients with a postnatal diagnosis. Long-term functional and radiologic outcomes were assessed.
  
  
  RESULTS
  Follow-up was a median 5.5 years (range, 2-15 years). Mean age at ablation was 2.5 years (range, 1 day-15 years). Chronic kidney disease developed at the end of follow-up in 96 patients (30%): 27 (19%) in group 1 and 69 (40%) in group 2 (P <.05). The mean nadir serum creatinine was 0.6 and 0.8 mg/dL in groups 1 and 2, respectively, and the mean final serum creatinine was 0.9 and 1.7 mg/dL, respectively (P <.05). Persistent upper tract dilatation was noted in 43% of group 1 patients and in 69% of group 2 patients (P <.05).
  
  
  CONCLUSIONS
  The potential for recovering renal function is believed to be significant in patients in whom early detection of PUVs and, hence, early intervention was performed. Antenatal screening and detection of these patients might play a significant role in protecting the upper tract and reducing the incidence of chronic kidney disease.
authors.affiliation: Pediatric Department, Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt; Pediatric Urology Unit, Urology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Electronic address: o_sarhan2004@yahoo.com.
authors.forename: Osama M
authors.initials: OM
authors.lastname: Sarhan
authors.forename: Tamer E
authors.initials: TE
authors.lastname: Helmy
authors.forename: Abdulhakim A
authors.initials: AA
authors.lastname: Alotay
authors.forename: Mustafa S
authors.initials: MS
authors.lastname: Alghanbar
authors.forename: Ziad M
authors.initials: ZM
authors.lastname: Nakshabandi
authors.forename: Ashraf T
authors.initials: AT
authors.lastname: Hafez
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014521:Urethra / Q000002:abnormalities*; D014718:Vesico-Ureteral Reflux / Q000188:drug therapy
chemical_list: D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003404:Creatinine