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Improving outcomes for patients born with posterior urethral valves

01 July 2022

Professor David Long and his team at University College London are looking to improve outcomes for patients born with posterior urethral valves (PUV).

In PUV the bladder can change and become less flexible. This affects the way urine can flow out of the body, increasing the risk of developing chronic kidney disease (CKD) and kidney failure. We have funded David and his team to explore this problem. David will construct a map of the bladder, detailing the changes in the bladder and will attempt to stop these changes occurring using a new drug. 

Professor David Long in the research lab
Prof David Long in the research lab

The problem 

Posterior urethral valves (PUV) blockages that stop the flow of urine along the tube from the bladder to the outside. They are present in 8,000 male births. The condition can be corrected by surgery at birth, but despite successful surgery, many patients are left with scarring in their bladders. This affects the way the bladder works and can cause ongoing problems. Around 50% of children can go on to develop chronic kidney disease (CKD) and between 15 and 20% of those born with PUV go on to develop kidney failure.  

If the map fits

Professor David Long and his team are going to study the scarring of the bladder and attempt to protect the bladder using a new treatment. David is going to build a highly detailed map of the bladder and how the individual cells contribute to the scarring process. Extra Cellular Matrix (ECM) is the scaffolding that holds tissues together and, in many diseases, cells change the way they make the ECM, which in turn changes the makeup of the tissue.

Through his new knowledge of how the cells of the bladder respond to PUV, David will be able to test several anti-scarring drugs to see if they might show potential in treating children with PUV and preventing them from developing kidney failure. 

What this might mean for kidney patients

If successful David and his team will be able to protect the function of the bladder in PUV and prevent kidney damage. This will stop patients progressing to CKD and kidney failure. The anti-scarring treatment would help patients avoid dialysis and kidney transplant.

Furthermore, David will graciously make his super-detailed bladder map publicly available. This will enable other scientists to use his data to better understand bladder function and make more discoveries! 

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