title: Antenatal Determinants of Long-Term Kidney Outcome in Boys with Posterior Urethral Valves.
abstract: BACKGROUND
  Posterior urethral valves (PUV) are the most important cause of end-stage renal disease (ESRD) in young boys. The objective of this report was to define the antenatal determinants of long-term postnatal renal outcome in this condition.
  
  
  METHODS
  This was a retrospective cohort analysis. The primary outcome was the development of ESRD defined as starting dialysis or receiving a preemptive kidney transplant.
  
  
  RESULTS
  Eighty-two cases of PUV were identified, with 17 (21%) developing ESRD at 6.1 ± 7.1 years. Cases developing ESRD were more likely diagnosed antenatally (41 vs. 19%, p = 0.05), had a younger gestational age (35.5 ± 3.4 weeks vs. 37.3 ± 2.1 weeks, p = 0.02), and on antenatal ultrasound scan were more likely to have oligohydramnios (60 vs. 26%, p = 0.02), renal cortical cysts (47 vs. 17%, p = 0.02), and the combination of oligohydramnios, renal cortical cysts, and increased renal echogenicity (47 vs. 9%, p = 0.002).
  
  
  CONCLUSIONS
  In boys with PUV, decreased gestational age, oligohydramnios, renal cysts, and the combination of oligohydramnios, cortical cysts, and echogenic kidneys were associated with ESRD, while the combination was an independent predictor of poor long-term postnatal kidney function.
authors.affiliation: Department of Pediatrics, British Columbia Children's Hospital, and Child and Family Research Institute, Vancouver, B.C., Canada.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Matsell
authors.forename: Simon
authors.initials: S
authors.lastname: Yu
authors.forename: Sarah Jane
authors.initials: SJ
authors.lastname: Morrison
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D007677:Kidney Function Tests; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies; D014521:Urethra / Q000002:abnormalities* / Q000601:surgery; D014524:Urethral Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014549:Urinary Incontinence / Q000150:complications / Q000453:epidemiology; D014552:Urinary Tract Infections / Q000150:complications / Q000453:epidemiology