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S7: NEPHROLOGY
Moderators: Gil Rushton (USA), Goedele Beckers (Netherlands)
ESPU Meeting on Thursday 15, October 2015, 10:56 - 11:32
10:56 - 10:59
S7-1
(PP)
★
SCREENING OF DISTAL RENAL TUBULAR ACIDOSIS AND GROWTH
RETARDATION IN POSTERIOR URETHRAL VALVE: IS THERE A ROLE FOR
BICARBONATE THERAPY IN IMPROVING GROWTH? A PROSPECTIVE
RANDOMIZED STUDY
M S ANSARI and Sachin A N
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Urology and renal transplantation, Lucknow,
INDIA
PURPOSE
Growth retardation is very common in children with posterior urethral valve [PUV] as a consequence of persistent renal
tubular acidosis [RTA]. This study intends to screen and diagnose complete and incomplete dRTA as a consequence of
PUV. We also hypothesized a therapeutic benefit from bicarbonate therapy on growth parameters in children with PUV.
MATERIAL AND METHODS
A prospective observational study comprising 100 children diagnosed with PUV were screened for dRTA and were
randomized for treatment with and without bicarbonate therapy respectfully. In a study group of 50 surgically treated
patients with PUV and normal estimated glomerular filtration rate (Group A), we prospectively evaluated the change in
height standard deviation scores (Z score and WHO percentile score) while they were on bicarbonate therapy. Age and
gender matched patients constituted the control group (n=50) Group B.
RESULTS
Complete dRTA was found in 35(70%) and 37(74%) of subjects in Group A and Group B respectively. Incomplete dRTA
was found in 10(20%) and 9(18%) of patients in Group A and Group B respectively. The mean follow-up period was
24.7±8.3 months. The increase in height SDS (∆ height SDS) was significantly greater in the bicarbonate group than in
the patients without bicarbonate (P<0.001). From the baseline values, the ∆ height SDS in the PUV patients on
bicarbonate and without bicarbonate therapy was 66% and 26% respectively.
CONCLUSIONS
This study emphasis the need for treating urologist to not only correct PUV, but also to have an high index of suspicion
regarding dRTA specifically Incomplete dRTA. Bicarbonate therapy improves height SDS in dRTA associated with PUV.