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Single centre experience: long term outcomes in spina bifida patients
Georgina Malakounides1, Frank Lee, Feilim Murphy
1Department of Paediatric Urology, St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT, UK. georgina@doctors.org.uk
Insights
Long-term renal function in spina bifida patients is generally good, with low rates of severe impairment. This study suggests improved survival and reduced renal complications, offering a more optimistic outlook for families.
Area of Science:
- Urology
- Pediatric Nephrology
- Spina Bifida Research
Background:
- Spina bifida is associated with significant renal morbidity and mortality.
- Historical data indicates a high risk of kidney complications in affected individuals.
Purpose of the Study:
- To evaluate long-term renal function in spina bifida patients.
- To assess mortality rates within a spina bifida cohort.
- To update prognostic information for families.
Main Methods:
- Prospective data collection from 1970-2011.
- Inclusion of spina bifida patients managed at a single center.
- Analysis of glomerular filtration rates, renal imaging, management, and mortality.
Main Results:
- 120 patients analyzed (mean age 20 years).
- 48% demonstrated normal renal function.
- Only 1.6% had severe renal impairment or end-stage renal failure.
- Overall mortality rate was 4.4%, with no deaths attributed to renal failure.
Conclusions:
- Current spina bifida patient outcomes show better renal function and survival than historical data suggests.
- Advancements in care have likely reduced renal morbidity and mortality.
- Counseling for families can be more optimistic regarding long-term survival.
Objective:
To determine our single centre experience of long term renal function and mortality rates of our cohort of spina bifida patients born since 1970.
Materials And Methods:
We collected a prospective database and included all patients born with spina bifida between 1970 and 2011 managed by our centre. Data we collected included the glomerular filtration rates, results of renal tract imaging, management strategies and mortalities.
Results:
Of 160 patients identified, 120 were included for analysis with a mean age of 20 years. In our cohort 48% (58/120) had normal renal function and only 1.6% (2/120) had severe renal impairment or end stage renal failure. There was a mortality rate of 4.4% and there were no deaths from renal failure.
Conclusion:
Spina bifida patients have been reported to have high mortality rates and high morbidity secondary to renal failure. Historical data does not appear to reflect current advancements and we would therefore be more optimistic when counselling families about long term survival into adulthood.
