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International Journal of Nephrology
Volume 2012, Article ID 345298, 4 pages
http://dx.doi.org/10.1155/2012/345298
Research Article

Outcome of Late Presentation of Posterior Urethral Valves in a Resource-Limited Economy: Challenges in Management

1Department of Pediatrics, Enugu State University Teaching Hospital, Enugu 400261, Enugu State, Nigeria
2Pediatric Nephrology Unit, Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku Ozalla 402108, Enugu State, Nigeria
3Pediatric Surgery Unit, Department of Surgery, Enugu State University Teaching Hospital, Enugu 400261, Enugu State, Nigeria
4Pediatric Surgery Unit, Department of Surgery, College of Medicine, University of Lagos, Idi Araba 100254, Lagos, Nigeria
5Pediatric Surgery Unit, Department of Surgery, University of Nigeria Teaching Hospital, Ituku Ozalla 402108, Enugu State, Nigeria

Received 1 May 2012; Accepted 23 August 2012

Academic Editor: Jaime Uribarri

Copyright © 2012 Odutola Israel Odetunde et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Delayed presentation of patients with posterior urethral valve with complications like severe urosepsis, uremia, and anemia are seen in our setting. Renal replacement therapy which should have been offered to these patients is not readily available for children in our country. The aim of this study is to determine the pattern of late presentation and outcome of management of posterior urethral valve in a resource-limited setting. A descriptive retrospective study (1997–2009) was conducted. Data including pattern of presentation, duration of symptoms, complications, and outcome of initial management were analyzed. Twenty-one patients were seen. The median age was 3 years (2 days–13 years). The mean duration of symptoms before presentation was 2.6 years. Nineteen patients (91%) presented with urosepsis while 8 patients (36%) presented with significant renal insufficiency. Laboratory findings varied from-mild-to marked elevation in serum creatinine. Radiological findings confirmed the diagnosis of posterior urethral valve. We concluded that late presentation is common in our setting. This is associated with high morbidity and mortality rates. Efforts at improving awareness and early diagnosis among the health team should be made to stem the tide.