Prognostic value of serum creatinine levels in children with posterior urethral valves treated by primary valve ablation
Received 28 March 2009; accepted 29 May 2009. published online 08 July 2009.
Abstract
Purpose
We evaluated the prognostic value of serum creatinine level at presentation and nadir creatinine during follow up for future renal function (RF) in children with posterior urethral valves (PUV).
Materials and methods
Between 1987 and 2004, 120 cases of PUV were treated initially at our hospital with valve ablation. Initial assessment included serum creatinine measurement, urine analysis and culture, renal ultrasonography and voiding cystourethrography. After valve ablation, renal ultrasound and serum creatinine measurement were repeated and thereafter during visits until the end of follow up.
Results
Follow up ranged from 2 to 12 years (mean=4.4). Renal insufficiency (RI) developed at the end of follow up in 44 patients (36.5%). The mean initial and nadir serum creatinine in the RI group was higher than in the normal RF group (P<0.05). With a cut-off value of 1mg/dl for initial and nadir serum creatinine, the incidence of RI was significantly different (P<0.05).
Conclusion
Our data confirm the high prognostic value of nadir serum creatinine after relief of valvular obstruction. Further, the serum creatinine level before valve ablation correlates significantly with long-term RF in children with PUV.
ABSTRACT