Chronic Kidney Disease Frequently Observed in Adults With Spina Bifida

We evaluated the association between chronic kidney disease and the current and background conditions of adults with spina bifida.

Patients with spina bifida (group A, n = 34) and patients with a history of pediatric encephalitis or spinal cord injury (group B, n = 23) who were older than 18 years between January 2013 and August 2022 were retrospectively analyzed. The chronic kidney disease-free survival was compared between groups. In each group, the congenital or pediatric background conditions (gender, disease type, history of febrile urinary tract infection, bladder augmentation, vesico-ureteral reflux, or detrusor overactivity) and current background conditions (age at last follow-up, ambulatory status, hypertension, and albuminuria) were compared between patients with or without chronic kidney disease.

The median age was 37 years (range 20-67 years). The median chronic kidney disease-free survival was younger in group A than group B (48.0 vs. 65.0 years, p = 0.0027). In group A, chronic kidney disease was associated with pediatric febrile urinary tract infection (p = 0.0018) and vesico-ureteral reflux (p = 0.0090), current hypertension (p < 0.001), and albuminuria (p = 0.0053). Multivariate analysis showed only hypertension was significantly associated with chronic kidney disease.

Young to middle-aged adults with spina bifida with a history of pediatric febrile urinary tract infection or vesico-ureteral reflux and those with current hypertension or albuminuria have an increased risk of chronic kidney disease, suggesting the need for renal function monitoring.