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Renal involvement in children with spina bifida

Jameela A Kari1, Osama Safdar, Roaa Jamjoom

  • 1Princesss Al-jawhara Center of Excellence in Research of Hereditary Disorders, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia. jkari@kau.edu.sa

Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia
|December 30, 2008
PubMed

Insights

Early clean intermittent catheterization (CIC) in children with myelomeningocele (MMC) significantly reduces urinary tract infections (UTI) and preserves renal function, preventing end-stage renal disease.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Neurology

Background:

  • Spinal dysraphism, including myelomeningocele (MMC), poses significant risks for renal scarring and failure in children.
  • Optimal management for these conditions is often lacking in developing countries, leading to poorer outcomes.
  • Early intervention is crucial for preserving renal function and preventing end-stage renal disease.

Purpose of the Study:

  • To evaluate the impact of early clean intermittent catheterization (CIC) on renal function and urinary tract health in children with MMC.
  • To compare outcomes between children receiving CIC and those not on therapy or non-compliant.
  • To highlight the need for increased awareness and proactive management of urinary tract complications in infants with spina bifida.

Main Methods:

  • Retrospective review of 33 newborns with spina bifida (myelomeningocele) born between 1997-2006.
  • Categorization into Group A (received CIC) and Group B (non-compliant or no therapy).
  • Analysis of data including MMC site, age, neurogenic bladder, vesicoureteral reflux (VUR), urinary tract infections (UTI), and serum creatinine levels.

Main Results:

  • 90% of patients had neurogenic bladder; 78% had VUR.
  • Children on CIC (Group A) experienced fewer UTIs per year (3.3) compared to Group B (6.6).
  • Group A showed a lower incidence of VUR (62%) and lower mean creatinine (38 µmol/L) than Group B (93% VUR, 50 µmol/L creatinine).

Conclusions:

  • Early intervention with CIC in children with MMC effectively preserves renal function.
  • Proactive management of urinary retention significantly reduces VUR and UTI incidence.
  • Increased awareness and implementation of early treatment are vital to prevent upper urinary tract disease and renal failure in infants with spina bifida.

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