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Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/57390
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dc.creatorMariana Affonso Vasconcelospt_BR
dc.creatorR. H. Makpt_BR
dc.creatorEduardo a. Oliveirapt_BR
dc.creatorA. C. Simões e Silvapt_BR
dc.creatorCristiane Dos Santos Diaspt_BR
dc.creatorI. R. Gomespt_BR
dc.creatorS. V. Figueiredopt_BR
dc.creatorM. C. L. Oliveirapt_BR
dc.creatorR. A. Carvalhopt_BR
dc.creatorT. R. Dumontpt_BR
dc.creatorS. V. Pinheiropt_BR
dc.date.accessioned2023-08-02T22:15:17Z-
dc.date.available2023-08-02T22:15:17Z-
dc.date.issued2018-11-24-
dc.citation.volume15pt_BR
dc.citation.issue2pt_BR
dc.citation.spage167.e1pt_BR
dc.citation.epage167.e8pt_BR
dc.identifier.doihttps://doi.org/10.1016/j.jpurol.2018.11.005pt_BR
dc.identifier.issn1477-5131pt_BR
dc.identifier.urihttp://hdl.handle.net/1843/57390-
dc.description.resumoBackground:Posterior urethral valves (PUVs) constitute the most common infravesical urinary obstruction in boys and are often accompanied by severe consequences to the lower and upper urinary tract. Currently, about two-thirds of diagnosis of PUVs has been suspected by prenatal ultrasonography findings. The aim of this study was to compare long-term clinical outcomes in two groups of patients with PUVs, with antenatal vs.postnatal diagnosis.Study design:This was a retrospective cohort study of 173 patients with PUVs systematically followed up in a tertiary center. Median follow-up time was 66.5 months (interquartile range [IQ], 11.4e147.9 months) for those patients who survived neonatal period. Seventy-nine (45.6%) patients were fol lowed up for more than 5 years and 55 (32%) for more than 10 years. For analysis, the cohort was stratified into two groups according to the clinical presentation (prenatal vs. postnatal). The events of interest were urinary tract infection (UTI), surgical interventions, proteinuria, hypertension, chronic kidney disease (CKD), and death. Survival analyses were performed to evaluate time until occurrence of the events.Results:Sixty-two patients (35.8%) were diagnosed by fetal sonography. Patients of postnatal group presented a higher incidence rate of UTI episodes (6.5, 95% confidence interval [CI], 4.9e8.3) than antenatal group (1.2, 95% CI, 0.4e2.7) (P < 0.001). Thirty-six patients (21%) presented hypertension, and 77 (44.5%) had persistent mild proteinuria. There was no significant difference in the estimated incidence of hypertension (P Z 0.28) and proteinuria (P Z 0.78) between antenatal and postnatal groups. The cumulative incidence of CKD stage 3 was estimated to be about 37% at 10 years of age, and 56% at 18 years of age. By survival analysis, there was no significant difference in the estimated incidence of CKD stage 3 (log-rank Z 0.32, P Z 0.57) and CKD stage 5 (log-rank Z 1.08, P Z 0.28, Figure) between antenatal and postnatal groups. Of 173 patients included in the analysis, 13 (7.5%) died during follow-up with a median age of 2.6 months(IQ, 15 dayse62 months). Survival analyses have not shown any significant difference in the estimated incidence of death between antenatal and postnatal groups (log-rank Z 1.38, P Z 0.24).Conclusion: The study findings did not corroborate the initial hypothesis that the rates of renal function declining in patients with PUVs would be attenuated by an early diagnosis and intervention after antenatal diagnosis.pt_BR
dc.format.mimetypepdfpt_BR
dc.languageengpt_BR
dc.publisherUniversidade Federal de Minas Geraispt_BR
dc.publisher.countryBrasilpt_BR
dc.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIApt_BR
dc.publisher.initialsUFMGpt_BR
dc.relation.ispartofJournal of Pediatric Urology-
dc.rightsAcesso Restritopt_BR
dc.subjectPosterior urethral valvespt_BR
dc.subjectFetal hydronephrosispt_BR
dc.subjectUrinary tract infectionpt_BR
dc.subjectChronic kidney diseasept_BR
dc.subjectHypertensionpt_BR
dc.subject.otherInfecções Urináriaspt_BR
dc.subject.otherInsuficiência Renal Crônicapt_BR
dc.subject.otherHipertensãopt_BR
dc.titlePosterior urethral valves: comparison of clinical outcomes between postnatal and antenatal cohortspt_BR
dc.typeArtigo de Periódicopt_BR
dc.url.externahttps://www.sciencedirect.com/science/article/pii/S1477513118304297?via%3Dihubpt_BR
dc.identifier.orcid0000-0001-6559-3300pt_BR
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