Mp50-14 a Further External Validation of the Posterior Urethral Valve Risk of Chronic Kidney Disease (Purk) Score: A New Prognostic Tool in Pediatric Urology

You have accessJournal of UrologyPediatrics III (MP50)1 May 2024MP50-14 A FURTHER EXTERNAL VALIDATION OF THE POSTERIOR URETHRAL VALVE RISK OF CHRONIC KIDNEY DISEASE (PURK) SCORE: A NEW PROGNOSTIC TOOL IN PEDIATRIC UROLOGY Jin Kyu (Justin) Kim, Priyank Yadav, Daniel Keefe, Chris Bitcon, Adree Khondker, Michael Chua, Mohd Sualeh Ansar, Juliane Richter, Joana Dos Santos, Armando J. Lorenzo, and Mandy Rickard Jin Kyu (Justin) KimJin Kyu (Justin) Kim , Priyank YadavPriyank Yadav , Daniel KeefeDaniel Keefe , Chris BitconChris Bitcon , Adree KhondkerAdree Khondker , Michael ChuaMichael Chua , Mohd Sualeh AnsarMohd Sualeh Ansar , Juliane RichterJuliane Richter , Joana Dos SantosJoana Dos Santos , Armando J. LorenzoArmando J. Lorenzo , and Mandy RickardMandy Rickard View All Author Informationhttps://doi.org/10.1097/01.JU.0001008684.57262.97.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Posterior urethral valves (PUV) are the most common etiology for congenital urethral obstruction and many progress to CKD. We aim to develop a scoring system using clinical variables at presentation to identify risk categories to individualize follow up and upper/lower urinary tract optimization. METHODS: Patients who presented with posterior urethral valves diagnosed prior to June 2022 from institution 1 (Canada) were included. The outcomes were eGFR at 1- and 5-year endpoints. We performed univariate analysis to determine potential predictors of CKD stage ≥3 at 5-years (defined as p≤0.1). Based on the ß value of the significant variables in backward logistic regression, a scoring system was developed. We performed external validation on a cohort of from institution 2 (India) and institution 3 (Canada). RESULTS: From institution 1, 106 patients had 1-year eGFR data and 72 patients had 5-year eGFR data. Based on this data, a new scoring system (PURK Score) was developed (Table 1). The PURK score risk-stratified patients at risk of CKD stage ≥3 at 1-year and 5-years of follow up. For institution 1, the model had excellent AUROC of 0.907 for 1-year and 0.873 for 5-year CKD ≥3 prediction. External validation of institution 2 showed AUROC of 0.932 and 0.960 for 1-year (n=11) and 5-year CKD ≥3 (n=9) predictions. External validation of institution 3 showed AUROC of 0.885 and 0.786 for 1-year (n=17) and 5-year CKD ≥3 (n=8) predictions. Evaluation of the combined cohort showed a AUROC of 0.905 and 0.888 for 1-year and 5-year CKD ≥3 predictions (Figure 1), with higher PURK score being well-correlated with higher proportion of patients having CKD ≥3 (Table 1). CONCLUSIONS: PURK score, internally validated/developed and externally validated from two institutions, provides accurate stratification of patients who are at risk of CKD stage ≥3. Further multi-institutional evaluation is underway for routine use in clinical promise. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e837 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Jin Kyu (Justin) Kim More articles by this author Priyank Yadav More articles by this author Daniel Keefe More articles by this author Chris Bitcon More articles by this author Adree Khondker More articles by this author Michael Chua More articles by this author Mohd Sualeh Ansar More articles by this author Juliane Richter More articles by this author Joana Dos Santos More articles by this author Armando J. Lorenzo More articles by this author Mandy Rickard More articles by this author Expand All Advertisement PDF downloadLoading ...