{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:43:14Z","timestamp":1786372994564,"version":"build-2736575974"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2019,11]]},"abstract":"\n Background and objectives<\/jats:title>\n Posterior urethral valve is the most common cause of bladder outlet obstruction in infants. We aimed to describe the rate and timing of kidney-related and survival outcomes for children diagnosed with posterior urethral valves in United States children\u2019s hospitals using the Pediatric Health Information System database.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n This retrospective cohort study included children hospitalized between January 1, 1992 and December 31, 2006, who were in their first year of life, had a diagnosis of congenital urethral stenosis, and underwent endoscopic valve ablation or urinary drainage intervention, or died. Records were searched up to December 31, 2018 for kidney-related mortality, placement of a dialysis catheter, and kidney transplantation. Cox regression analysis was used to identify risk factors, and Kaplan\u2013Meier survival analysis used to determine time-to-event probability. Subgroup survival analysis was performed with outcomes stratified by the strongest identified risk factor.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Included were 685 children hospitalized at a median age of 7 (interquartile range, 1\u201337) days. Thirty four children (5%) died, over half during their initial hospitalization. Pulmonary hypoplasia was the strongest risk factor for death (hazard ratio, 7.5; 95% confidence interval [95% CI], 3.3 to 17.0). Ten-year survival probability was 94%. Fifty-nine children (9%) underwent one or more dialysis catheter placements. Children with kidney dysplasia had over four-fold risk of dialysis catheter placement (hazard ratio, 4.6; 95% CI, 2.6 to 8.1). Thirty-six (7%) children underwent kidney transplant at a median age of 3 (interquartile range, 2\u20138) years. Kidney dysplasia had a nine-fold higher risk of kidney transplant (hazard ratio, 9.5; 95% CI, 4.1 to 22.2).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patients in this multicenter cohort with posterior urethral valves had a 5% risk of death, and were most likely to die during their initial hospitalization. Risk of death was higher with a diagnosis of pulmonary hypoplasia. Kidney dysplasia was associated with a higher risk of need for dialysis\/transplant.<\/jats:p>\n <\/jats:sec>\n \n Podcast<\/jats:title>\n This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2019_10_03_CJN04350419.mp3<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.04350419","type":"journal-article","created":{"date-parts":[[2019,10,3]],"date-time":"2019-10-03T15:25:12Z","timestamp":1570116312000},"page":"1572-1580","source":"Crossref","is-referenced-by-count":35,"title":["Survival and Kidney Outcomes of Children with an Early Diagnosis of Posterior Urethral Valves"],"prefix":"10.2215","volume":"14","author":[{"given":"Katherine W.","family":"Herbst","sequence":"first","affiliation":[{"name":"Department of Research,"},{"name":"Division of Urology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Tomlinson","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Connecticut Children\u2019s Medical Center, Hartford, Connecticut;"},{"name":"Department of Pediatrics, University of Connecticut Health Center, Farmington, Connecticut;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gina","family":"Lockwood","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maua H.","family":"Mosha","sequence":"additional","affiliation":[{"name":"Department of Research,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, University of Texas Health San Antonio, San Antonio, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"D'Alessandri-Silva","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Connecticut Children\u2019s Medical Center, Hartford, 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