ESPU Congress 2018 - Abstract Book

11–14 APRIL, 2018, HELSINKI, FINLAND

S10: ADOLESCENT UROLOGY 2

Moderators: Rosalia Misseri (USA), Dan Wood (UK)

ESPU Meeting on Thursday 12, April 2018, 14:38–15:15

14:38–14:43

S10-1 (LO)

ADOLESCENTS WITH POSTERIOR URETHRAL VALVE:

KIDNEY AND BLADDER FUNCTION AT TRANSITION

TO ADULT CARE

Michal MATERNIK

, Ilona CHUDZIK

, Andrzej GOLEBIEWSKI

and

Aleksandra ZUROWSKA

1) Medical University of Gdansk, Pediatric Nephrology and Hypertension, Gdansk, POLAND - 2) Medical University

of Gdansk, Pediatric Surgery and Urology for Children and Adolescents, Gdansk, POLAND

PURPOSE

The short-term prognosis for boys with posterior urethral valves (PUV) has improved in recent dec-

ades, but the long-term outcome for kidney and bladder function are not well defined. Our purpose

was to report the incidence of bladder and kidney dysfunctiion in PUV adolescent patients at the

time of transition to adult care.

MATERIAL AND METHODS

The data of 41 boys with PUV were analyzed at time of transition to adult care. The median follow-

up after valve ablation was 16 years (15–18yrs). Outcome measures were defined as kidney

and urinary tract damage or loss of function. Kidney damage was assessed by ultrasound (lack

of corticomedullary differentiation) and kidney function by eGFR with KDOQI categorization of

Chronic Kidney Disease (CKD). Urinary tract damage was assessed by ultrasound (presence of

hydronephrosis) and bladder function by bladder diary (diurnal and/or nocturnal incontinence) and

uroflow measurements (bladder capacity (BC) and post void residual (PVR)).

RESULTS

34 boys (83 %) of subjects developed CKD. The majority (49 %) had CKD1 with normal eGFR, the

remaining 34 % had decreased eGFR (17 %-CKD2, 7 %-CKD3, 2 %-CKD4 ) with 2 boys requir-

ing renal replacement therapy (5 %-CKD5). 29 % received antihypertensive treatment to control

elevated blood pressure. Kidney ultrasound showed loss of corticomedullary differentiation in 60 %

and persistent hydronephrosis in 51 % of the cohort. Incontinence was reported by 24 %. Uroflow

revealed a bladder capacity above 150 % of EBC (expected bladder capacity for age) in 19 (46 %)

and PVR greater than 10 % of bladder capacity in 13 (31 %).

CONCLUSIONS

CKD was present in 83 % boys with PUV and 46 % have bladder dysfunction at time of transition

to adult care. Adolescent boys with PUV require close surveillance and active treatment when

transferred to adult nephrology and urology care due to the high risk of developing both ESRD and

bladder insufficiency.