Prediction of need for intervention in posterior urethral valves: Use of urine osmolality

Prediction of need for intervention in posterior urethral valves: Use of urine osmolality AimRenal tubular dysfunction (RTD) causing obligate production of hypoosmolar urine in boys with posterior urethral valves (PUVs) has been described. It is not known how clinically significant this is. We hypothesize that a feedback loop is present in many PUV boys who suffer deterioration of their lower urinary tract (LUT). RTD results in hypoosmolar urine, obligate polyuria, and bladder stretch-injury. The increasing back-pressure worsens RTD, thus exacerbating the injury. Coexisting renal dysplasia and acquired renal scarring exacerbate this.We compared the concentrating ability (random clinic urine osmolality) of PUV boys who had no LUT deterioration to those who required intervention, examining the confounding effect of renal impairment with a subgroup analysis comparing those with plasma creatinine ≤80μmol/l. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Pediatric Surgery Elsevier

Prediction of need for intervention in posterior urethral valves: Use of urine osmolality

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Publisher
Elsevier
Copyright
Copyright © 2017 Elsevier Ltd
ISSN
0022-3468
D.O.I.
10.1016/j.jpedsurg.2017.11.026
Publisher site
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Abstract

AimRenal tubular dysfunction (RTD) causing obligate production of hypoosmolar urine in boys with posterior urethral valves (PUVs) has been described. It is not known how clinically significant this is. We hypothesize that a feedback loop is present in many PUV boys who suffer deterioration of their lower urinary tract (LUT). RTD results in hypoosmolar urine, obligate polyuria, and bladder stretch-injury. The increasing back-pressure worsens RTD, thus exacerbating the injury. Coexisting renal dysplasia and acquired renal scarring exacerbate this.We compared the concentrating ability (random clinic urine osmolality) of PUV boys who had no LUT deterioration to those who required intervention, examining the confounding effect of renal impairment with a subgroup analysis comparing those with plasma creatinine ≤80μmol/l.

Journal

Journal of Pediatric SurgeryElsevier

Published: Feb 1, 2018

References

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