Evidence map›Paper›PMID 39932574›Full record

ArticlePediatric nephrology (Berlin, Germany)2025

Development and international validation of a novel multivariate prognostic tool: posterior urethral valve risk of chronic kidney disease (PURK) score.

Jin Kyu Kim, Priyank Yadav, Chris Bitcon, Daniel Keefe, Assia Comella, Kiarash Taghavi, Ribal Kattini, Carol A Davis-Dao, Antoine E Khoury, Adree Khondker and 14 more

Abstract readMulticenter StudyValidation Study
PubMed Publisher
In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Jin Kyu KimDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. kimjink@iu.edu.ORCID 0000-0003-0964-9503
Priyank YadavSanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Chris BitconIWK Hospital for Children, Halifax, NS, Canada.
Daniel KeefeIWK Hospital for Children, Halifax, NS, Canada.
Assia ComellaMonash Children's Hospital, Victoria, Melbourne, Australia.
Kiarash TaghaviMonash Children's Hospital, Victoria, Melbourne, Australia.
Ribal KattiniMonash Children's Hospital, Victoria, Melbourne, Australia.
Carol A Davis-DaoChildren's Hospital of Orange County (CHOC), Orange, CA, USA.
Antoine E KhouryChildren's Hospital of Orange County (CHOC), Orange, CA, USA.
Adree KhondkerDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
Michael ChuaDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
Elias J WehbiChildren's Hospital of Orange County (CHOC), Orange, CA, USA.
Kai-Wen ChuangChildren's Hospital of Orange County (CHOC), Orange, CA, USA.
Stephany A HeidiChildren's Hospital of Orange County (CHOC), Orange, CA, USA.
Zhan Tao Peter WangWestern University, London, ON, Canada.
Sumit DaveWestern University, London, ON, Canada.
Timothy BoswellChildren's Hospital of Alabama, Birmingham, AL, USA.
Brenton T BicknellChildren's Hospital of Alabama, Birmingham, AL, USA.
Mohd Sualeh AnsariSanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Rodrigo RomaoDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
Juliane RichterDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
Joana Dos SantosDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
Armando J LorenzoDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
Mandy RickardDivision of Urology, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic kidney disease (CKD) affects up to 40% of children diagnosed with posterior urethral valves (PUV). This study aimed to develop and validate a risk stratification tool based on clinical variables available at presentation to predict CKD progression in children with PUV.

methodsThis multicenter retrospective cohort study included data from 283 children diagnosed with PUV before 12 months of age, treated at seven pediatric centers across four countries. Patients were followed for a minimum of one year to assess CKD progression. Using patients from the largest institutional cohort, clinical variables at initial presentation, including baseline creatinine, high-grade vesicoureteral reflux (VUR), failure to thrive (FTT), and kidney dysplasia, were identified through backward logistic regression analysis and used to develop the Posterior Urethral Valve Risk of Kidney disease (PURK) score, which was then externally validated at six centers.

resultsThe PURK score identified baseline creatinine > 150 µmol/L, high-grade VUR, FTT, and kidney dysplasia as significant predictors of CKD stage ≥ 3. In the development cohort, the score achieved excellent predictive accuracy, with an area under the receiver operating characteristic curve (AUROC) of 0.907 at 1 year and 0.873 at 5 years. External validation across six additional institutions confirmed high predictive value, with AUROCs of 0.849 and 0.877 at 1 and 5 years, respectively.

conclusionsThe PURK score is a reliable tool for predicting CKD progression in children with PUV, using accessible clinical data. Its implementation may support individualized care, improve family counseling, and allow comparison of similar risk-group patients for both clinicians and researchers.

Indexed as

Renal Insufficiency, ChronicUrethraChildChild, PreschoolCreatinineDisease ProgressionFemaleHumansInfantMalePredictive Value of TestsPrognosisRetrospective StudiesRisk AssessmentRisk FactorsROC CurveCreatinineChronic kidney diseaseCKDPosterior urethral valvePrediction modelPURK scorePUV

Identifiers

PMID39932574

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.