Kidney Week

Abstract: TH-PO1194

Kidney Outcomes in Posterior Urethral Valves: The Role of Health Care Access and Bladder Dysfunction

Session Information

• Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Park, Seohyeon, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada

Seohyeon Park

• Bae, Hans, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada

Hans Bae

• Zhang, Qian, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada

Qian Zhang, MPH

• Jin, Xin, BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada

Xin Jin

• Alshalan, Abdullah Abdulrahman N, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada

Abdullah Abdulrahman N Alshalan, MD

• Chae, Hyunwoong Harry, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada

Hyunwoong Harry Chae

• Wong, Alyssa C., BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada

Alyssa C. Wong

• Matsell, Douglas G., The University of British Columbia Department of Pediatrics, Vancouver, British Columbia, Canada

Douglas G. Matsell, MD

• Bone, Jeffrey N., BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada

Jeffrey N. Bone, MSc, PhD

• Afshar, Kourosh, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada

Kourosh Afshar, MD, MSc

• Skarsgard, Erik, The University of British Columbia Department of Surgery, Vancouver, British Columbia, Canada

Erik Skarsgard, MD

• MacNeily, Andrew, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada

Andrew MacNeily, MD

• Kim, Soojin, The University of British Columbia Department of Urologic Sciences, Vancouver, British Columbia, Canada

Soojin Kim, MD, MSc

Background

Posterior urethral valves (PUV) are a rare congenital disorder characterized by anomalous membranous folds in the male urethra, leading to impaired urinary outflow. Patients with PUV are at increased risk of chronic kidney disease (CKD) and bladder dysfunction. Although several prognostic factors for renal impairment have been identified, the influence of healthcare access and early bladder dysfunction on long-term renal outcomes remains underexplored. This study evaluated novel predictors of renal outcomes in pediatric patients with PUV.

Methods

A single-centre retrospective cohort study reviewed pediatric patients with PUV managed at a tertiary pediatric centre from 2000–2019. Multivariable linear and logistic regression analyses evaluated associations between healthcare access factors—transfer status, distance to hospital, and Canadian Index of Multiple Deprivation (CIMD)—and renal outcomes including creatinine level and CKD stage (≥3 vs <3) at last follow-up. Due to the limited subset of patients with available urodynamic findings, univariable analyses were performed for bladder dysfunction variables including bladder compliance, detrusor activity, and involuntary detrusor contractions.

Results

Among 62 patients with PUV, the median distance to hospital was 69.5 km (IQR 23–121), and the median CIMD score was 3.00 (IQR 2.25–3.31). Overall, 51.6% were transferred to the management site, and 24 (44.4%) had CKD stage ≥3. Greater distance to hospital was associated with higher creatinine at last follow-up (β = 0.04, 0.008–0.071). Transfer status and CIMD score demonstrated non-significant associations with higher creatinine. Higher CIMD scores were also associated with increased odds of CKD stage ≥3 (OR = 1.71, 0.67–4.66), although not statistically significant. Univariable analyses of decreased bladder compliance, overactive detrusor activity, and involuntary detrusor contractions demonstrated non-significant associations with worse renal outcomes.

Conclusion

Greater distance to hospital was associated with higher creatinine at last follow-up. Although bladder dysfunction variables and higher CIMD score were not significantly associated with renal outcomes, the observed trends toward higher creatinine and CKD stages warrant further investigation in larger cohorts evaluating the role of healthcare access and early bladder dysfunction in long-term renal outcomes among patients with PUV.