Abstract: SA-PO0678
Characterization of Clinical, Systemic, and Socioeconomic Factors That May Affect the Timing of Initial Management of Patients with Posterior Urethral Valves
Session Information
- Pediatric Nephrology: Transplantation, Hypertension, AKI, Genetics, and Developmental Diseases
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Bae, Hans, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Chae, Hyunwoong Harry, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Jin, Xin, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Alshalan, Abdullah Abdulrahman N, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada
- Matsell, Douglas G., The University of British Columbia Department of Pediatrics, Vancouver, British Columbia, Canada
- Bone, Jeffrey N, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada
- Zhang, Qian, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada
- Afshar, Kourosh, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada
- Skarsgard, Erik, The University of British Columbia Department of Pediatrics, Vancouver, British Columbia, Canada
- MacNeily, Andrew, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada
- Kim, Soojin, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada
Background
To characterize clinical, system, and socioeconomic factors as potential barriers to healthcare access, measured by timing of posterior urethral valve (PUV) management.
Methods
We retrospectively reviewed PUV patients managed at our institution from 2000-2019. Primary outcomes were time to first imaging (renal ultrasound and/or voiding cystourethrogram) and surgery. Univariate analyses assessed associations with clinical (antenatal suspicion, prematurity), system (NICU admission, transfer status, hospital distance), and socioeconomic factors. Socioeconomic status was assessed using the Canadian Index of Multiple Deprivation (CIMD) scores and quintiles, which include situational vulnerability, residential instability, economic dependency, and ethnocultural composition.
Results
62 PUV patients were included. Median age at imaging was 5 days and at surgery was 14 days. Antenatal suspicion of PUV was present in 53.3% (32/60), prematurity in 27.6% (16/58), NICU admission in 57.7% (30/52), and transfer from another hospital in 51.7% (30/58) of patients. Median distance from hospital was 69.8 km. Median CIMD scores were: situational vulnerability –0.25, residential instability –0.21, economic dependency –0.36, and ethnocultural composition –0.39.
Antenatal suspicion of PUV was associated with earlier imaging (p < 0.001) and surgery (p < 0.001). Prematurity was also associated with earlier imaging (p = 0.048) and surgery (p = 0.028). Neonatal intensive care unit (NICU) admission was associated with both earlier imaging (p = 0.002) and surgery (p = 0.02). Higher ethnocultural composition scores were associated with a longer time to surgery (p = 0.05). Imaging and surgery timing were not significantly associated with transfer status, distance from hospital, or other CIMD dimensions.
Conclusion
Patients with antenatally suspected PUV, prematurity, and NICU admission had earlier imaging and surgery. Most socioeconomic factors were not barriers to PUV management, but higher ethnocultural composition scores were associated with longer time to surgery. Clinical and system factors appear to primarily drive timely PUV management, though disparities related to ethnocultural composition may merit further study.