neral population.This justifies close kidney health surveillance among children with posterior urethral valves and optimized transitions to adult urologic care. Background Posterior urethral valves represent the most common cause of lower urinary tract obstruction in male infants (approximately 1/4000 live births). Long-term kidney outcomes of posterior urethral valves remain uncertain. We aimed to determine the time-varying risk of major adverse kidney events (MAKE) following children with posterior urethral valves into adulthood. Methods A population-based retrospective cohort study of all male children (<2 years) diagnosed with posterior urethral valves between 1991 and 2021 in Ontario, Canada. Comparator cohorts were (1) male general population and (2) male children with pyeloplasty (both <2 years). The primary outcome was MAKE (death, long-term KRT [dialysis or kidney transplant], or CKD). Time to MAKE was analyzed using multivariable-adjusted Cox proportional hazards models. We censored for provincial emigration or administrative censoring (March 31, 2022). Results We included 727 children with posterior urethral valves, 855 pyeloplasty comparators, and 1,013,052 general population comparators. The median follow-up time was 16.6 years (Q1–3, 8.6–24.5) overall. Throughout follow-up, 32% of children with posterior urethral valves developed MAKE versus 1% of the general population and 6% of pyeloplasty comparators. Their adjusted hazard ratio for MAKE was 36.6 (95% confidence interval, 31.6 to 42.4) versus the general population. The risk of developing MAKE declined over the first 5 years after posterior urethral valve diagnosis but remained elevated for >30-year follow-up. Children with posterior urethral valves were also at higher risk of death, CKD, long-term KRT, hypertension, and AKI than the general population or pyeloplasty comparators. Conclusions Children with posterior urethral valves are at higher risk of adverse long-term kidney outcomes well into adulthood....

中文翻译：

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尿道后瓣膜儿童的长期肾脏结局：一项基于人群的队列研究


神经种群。这证明了对患有后尿道瓣膜的儿童进行密切肾脏健康监测和优化过渡到成人泌尿科护理是合理的。背景 尿道后瓣膜是男婴下尿路梗阻的最常见原因（约 1/4000 活产婴儿）。后尿道瓣膜的长期肾脏结局仍不确定。我们旨在确定尿道后瓣膜患儿成年后主要不良肾脏事件 （MAKE） 的时变风险。方法 一项基于人群的回顾性队列研究，研究对象是 1991 年至 2021 年间在加拿大安大略省诊断患有后尿道瓣膜的所有男性儿童 （<2 岁）。对照组是 （1） 男性一般人群和 （2） 患有肾盂成形术的男性儿童 （均为 <2 岁）。主要结局是 MAKE（死亡、长期 KRT [透析或肾移植] 或 CKD）。使用多变量调整的 Cox 比例风险模型分析 MAKE 时间。我们对省级移民或行政审查进行了审查（2022 年 3 月 31 日）。结果 我们纳入了 727 例尿道后瓣膜患儿、855 例肾盂成形术对照和 1,013,052 例普通人群对照。总体中位随访时间为 16.6 年 （Q1-3,8.6-24.5）。在整个随访过程中，32% 的尿道后瓣膜患儿发生 MAKE，而一般人群的 1% 和肾盂成形术的对照组为 6%。与一般人群相比，他们的 MAKE 调整后风险比为 36.6 （95% 置信区间，31.6 至 42.4）。在尿道后瓣膜诊断后的前 5 年内，发生 MAKE 的风险下降，但在 >30 年的随访中保持升高。 与一般人群或肾盂成形术对照组相比，患有后尿道瓣膜的儿童发生死亡、CKD、长期 KRT、高血压和 AKI 的风险也更高。结论 后尿道瓣膜患儿成年后发生不良长期肾脏结局的风险更高。