EN
TÜRKÇE
Oral Presentation - 26
Late presentation of boys with posterior urethral valves in Uganda and their estimated survival based on serum creatinine levels
Jan Trachta 1, Valeria Testa 2, Geert Morren 3, Rita Gobet 3
1 Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, The Czech Republic and Emergency Childrens Surgical Hospital, Entebbe, Uganda
2 Pediatric Surgery Department University of Brescia, Italy and Emergency Childrens Surgical Hospital in Entebbe, Uganda
3 Emergency Childrens Surgical Hospital, Entebbe, Uganda
Purpose
This study aimed to evaluate the prevalence of chronic kidney disease (CKD) based on serum creatinine levels in boys with posterior urethral valves (PUV) diagnosed late and previously untreated. We also sought to estimate their survival time in Uganda, where dialysis is limited and kidney transplantation is unavailable.
Methods
We retrospectively reviewed data from boys with PUV treated between 2021 and 2024. Serum creatinine levels on admission prior to endoscopic valve incision were converted to estimated glomerular filtration rate (eGFR) using the classic Schwartz formula. Follow-up creatinine levels were compared with baseline values using a paired t-test. CKD staging was based on eGFR, and median time to end-stage renal disease (ESRD) was estimated by extrapolating from large-scale published studies.
Results
Of 64 patients identified, 22 were excluded due to prior valve incision or vesicostomy performed elsewhere. The remaining 42 boys, aged 5 months to 13 years (median 37 months), presented late with symptoms such as dribbling, straining, or urinary tract infections. Among 32 patients with available follow-up, serum creatinine on admission ranged from 0.21 to 6.24 mg/dL (mean 0.82 ± 1.12; median 0.48), while follow-up values ranged from 0.19 to 2.02 mg/dL (mean 0.65 ± 0.46; median 0.50). The change was not statistically significant (p = 0.254). Seventeen boys (40%) were classified as having CKD: stage 2 (n=7), stage 3a/3b (n=6), stage 4 (n=2), and ESRD (n=2). The estimated median time to progression from CKD stages 2–4 to ESRD was under 4.5 years.
Conclusion
In boys with late-diagnosed PUV, creatinine levels did not significantly improve after valve ablation, and 40 % developed CKD. Their estimated median time to ESRD was less than 4.5 years, underscoring the need for earlier detection and improved renal support in low-resource settings.