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Early clean intermittent catheterization may not prevent dimercaptosuccinic acid renal scan abnormalities in children

Jason Woo1, Kerrin Palazzi1, Jerry Dwek2

  • 1UC San Diego Health System, Department of Urology, 200 W Arbor Dr. #8897, San Diego, CA 92103-8897, USA.

Journal of Pediatric Urology
|October 8, 2013
PubMed

Insights

Early clean intermittent catheterization (CIC) may not prevent kidney damage in children with spinal dysraphism. A study found that starting CIC from birth was a predictor of kidney damage, not preservation.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Spinal Cord Medicine

Background:

  • Spinal dysraphism presents significant challenges in pediatric urological management.
  • Renal preservation is a key concern in managing these complex conditions.
  • Dimercaptosuccinic acid (DMSA) scans are crucial for assessing renal damage.

Purpose of the Study:

  • To investigate the association between early clean intermittent catheterization (CIC) and renal preservation in children with spinal dysraphism.
  • To identify risk factors for upper tract damage in this patient population.

Main Methods:

  • Retrospective review of 100 pediatric patients with spinal defects.
  • Analysis of DMSA scans for renal cortical loss (scarring or >15% differential function difference).
  • Multivariate regression analysis to determine predictors of kidney damage.

Main Results:

  • 43% of patients showed renal cortical loss on DMSA scans.
  • Early CIC initiation (from birth) was a significant predictor of kidney damage (OR 9.26).
  • Other predictors included age at DMSA scan, history of VUR, and hydronephrosis.

Conclusions:

  • Early initiation of CIC may not be associated with improved renal preservation in pediatric spinal dysraphism.
  • The findings suggest that early CIC might be a marker for more severe underlying conditions leading to kidney damage.
Abstract

Keywords:
Clean intermittent catheterizationDimercaptosuccinic acidMyelodysplasiaSpina bifida

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