GROWTH RETARDATION IN BOYS WITH POSTERIOR URETHRAL VALVES WITH AND WITHOUT RENAL FAILURE
Live Lundar, MD, Gunnar Aksnes, PHD, Ragnhild Emblem, PHD.
Oslo University Hospital, Oslo, Norway.
GROWTH RETARDATION IN BOYS WITH POSTERIOR URETHRAL VALVES WITH AND WITHOUT RENAL FAILURE
BACKGROUND
Growth retardation in children with chronic kidney disease (CKD) is well documented. In recent years, the awareness of affected growth in patients with congenital malformations in general, has increased. We aim to study growth in children with obstructive uropathy with and without renal failure, by describing a cohort of boys with posterior urethral valves (PUV).
METHODS
Hospital files of 43 patients born 2005-2015 with PUV was searched for clinical data including height, weight and renal function. All patients were diagnosed with PUV within the first year of life. Chronic renal failure is defined as GFR<60 ml/min/1.73m2 of more than 3 months duration (CKD stage 3-5). Z-scores or standard deviation scores (SDS) for height-for-age (HFA) were calculated. Growth retardation is defined as SDS-HFA < -1.64 and stunting is defined as SDS-HFA < - 2.
RESULTS
We identified 43 cases of PUV. The prevalence of chronic renal failure was 25.6%. Clinical data is described in Table 1.
| Table 1 | Total cases of PUV N=43 | PUV with renal failure (CKD 3-5) N=11 | PUV with normal renal function N=32 |
| Prenatal diagnosis | 24 (55.8%) | 8 (72.7%) | 16 (50.0%) |
| Gestational age mean | 37.7 weeks | 36.7 weeks | 38.1 weeks |
| Birth weight mean | 3295 gram | 3313 gram | 3288 gram |
| Median SDS-HFA | -0.27 | -0.50 | -0.26 |
| SDS-HFA < -1.64 | 9 cases (20.9%) | 4 cases (36.3%) | 5 cases (15.6%) |
| SDS-HFA < -2.00 | 6 cases (14.0%) | 3 cases (27.3%) | 3 cases (9.3%) |
| Follow-up mean (range) | 3.2 years (1.2-11.3) | 4.8 years (1.3-7.8) | 3.5 years (1.2-11.3) |
CONCLUSIONS
We found a prevalence of growth retardation of 20.9% and 14.0% stunting in PUV-boys. Both growth retardation and stunting is more common in patients with renal failure, but numbers are high also in patients with normal renal function. Our findings should be confirmed in a larger cohort of boys with PUV and further investigation could identify risk factors. Multidisciplinary follow-up is necessary to prevent growth impairment in children with congenital malformations of the urinary tract.
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