{"id":20270,"date":"2024-08-21T14:56:39","date_gmt":"2024-08-21T18:56:39","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=20270"},"modified":"2024-08-26T15:02:16","modified_gmt":"2024-08-26T19:02:16","slug":"long-term-kidney-outcomes-in-children-with-posterior-urethral-valves","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/long-term-kidney-outcomes-in-children-with-posterior-urethral-valves\/","title":{"rendered":"Long-term kidney outcomes in children with posterior urethral valves: a population-based cohort study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Posterior urethral valves represent the most common cause of lower urinary tract obstruction in male infants (\u223c1\/4000 live births). Long-term kidney outcomes of posterior urethral valves remain uncertain. We aimed to determine the time-varying risk of major adverse kidney events (MAKE) following children with posterior urethral valves into adulthood.<\/p>\n<p><strong>Methods<\/strong> \u2014 A population-based retrospective cohort study of all males (&lt;2 years) diagnosed with posterior urethral valves between 1991-2021 in Ontario, Canada. Comparator cohorts were: 1) male general population and 2) male pyeloplasty patients (both &lt;2 years). The primary outcome was MAKE (death, long-term kidney replacement therapy [dialysis or kidney transplant], or chronic kidney disease). Time-to-MAKE was analyzed using multivariable-adjusted Cox proportional hazards models. We censored for provincial emigration, or administrative censoring (March 31, 2022).<\/p>\n<p><strong>Results<\/strong> \u2014 We included 727 children with posterior urethral valves, 855 pyeloplasty comparators, and 1,013,052 general population comparators. Median follow-up time was 16.6 years (Q1-3 8.6-24.5) overall. Throughout follow-up, 32% of children with posterior urethral valves developed MAKE vs. 1% of the general population and 6% of pyeloplasty comparators. Their adjusted hazard ratio for MAKE was 36.6 (95%CI 31.6-42.4) vs. the general population. The risk of developing MAKE declined over the first 5 years after posterior urethral valves diagnosis but remained elevated for &gt;30-year follow-up. Children with posterior urethral valves were also at higher risk of death, chronic kidney disease, long-term kidney replacement therapy, hypertension, and acute kidney injury than general population or pyeloplasty comparators.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Children with posterior urethral valves are at higher risk of adverse long-term kidney outcomes well into adulthood.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Posterior urethral valves represent the most common cause of lower urinary tract obstruction in male infants (\u223c1\/4000 live births). Long-term kidney outcomes of posterior urethral valves remain uncertain. We aimed to determine the time-varying risk of major adverse kidney events (MAKE) following children with posterior urethral valves into adulthood. Methods \u2014 A population-based [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[46,49],"migration-helper-qa-sample-set":[],"class_list":["post-20270","journal_article","type-journal_article","status-publish","hentry","topic-internal-medicine","topic-kidney-disease"],"acf":{"citation":"Robinson CH, Rickard M, Jeyakumar N, Smith G, Richter J, Van Mieghem T, Santos JD, Chanchlani R, Lorenzo AJ.<em> J Am Soc Nephrol<\/em>. 2024; Aug 21 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1681\/asn.0000000000000468","ices_scientist":[1194],"site":[6739],"research_program":[6743],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Long-term kidney outcomes in children with posterior urethral valves: a population-based cohort study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Posterior urethral valves represent the most common cause of lower urinary tract obstruction in male infants (\u223c1\/4000 live births). 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