Document Detail

Posterior urethral valves: preliminary observations on the significance of plasma Renin activity as a prognostic marker.
MedLine Citation:
PMID:  15643266     Owner:  NLM     Status:  MEDLINE    
PURPOSE: A significant number of children with posterior urethral valves (PUVs) have chronic renal failure due to tubulointerstitial damage. Activation of the renin-angiotensin system is known to inflict this injury. We investigated the role of plasma renin activity (PRA) in patients with PUVs and sought to establish a relationship between renal damage and PRA. MATERIALS AND METHODS: The records of patients with PUVs were reviewed regarding the time of valve ablation, serum creatinine, scars, grade of reflux and glomerular filtration rate (GFR). PRA was measured before and after valve ablation. RESULTS: A total of 25 patients had PUVs (mean age 3.2 +/- 2.4 years, mean period of observation 4.5 +/- 1.2 years). Mean PRA was increased before valve ablation in all patients irrespective of age, and decreased after ablation. Of 25 patients 14 (56%) had renal damage, with a mean PRA of 36 +/- 4.5 ng/ml per hour compared to 26 +/- 8.2 ng/ml per hour in patients with normal renal function (chi-square 4.2 p = 0.01). Of the 14 patients with renal damage 9 (64%) had normal GFR at age 1 year but increased PRA. Of these 14 patients the accepted criteria for renal damage of increased serum creatinine, high grade reflux, scars and decreasing GFR were present in only 6 (43%), 3 (21%), 2 (14%) and 4 (29%), respectively. PRA was increased in all 14 cases. CONCLUSIONS: PRA was increased before valve ablation and decreased after ablation. It is increased in patients with early renal damage. Our preliminary observations indicate that PRA may be helpful in identifying patients with early renal damage.
Minu Bajpai; Akshay Pratap; Madhavi Tripathi; C S Bal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  173     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-11     Completed Date:  2005-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  592-4     Citation Subset:  AIM; IM    
Departments of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi-110029, India.
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MeSH Terms
Biological Markers / blood
Child, Preschool
Follow-Up Studies
Renin / blood*
Urethra / abnormalities*
Reg. No./Substance:
0/Biological Markers; EC

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