Article ID: oa.2021.0200
Among children with spina bifida, more than 90% of cases with spina bifida aperta and approximately 40% with spina bifida occulta present with lower urinary tract dysfunction, which occasionally causes renal impairment. In this retrospective study, we aimed to investigate the clinical characteristics associated with renal impairment in children with spina bifida who were treated with clean intermittent catheterization and underwent 99mTc-dimercaptosuccinic acid (DMSA) kidney scanning at our center. Renal impairment was defined as Group 2 or 3 using a classification based on DMSA scanning developed by Reflux Nephropathy Forum, Japan. Of the 62 patients enrolled, 15 (24%) were suffering from renal impairment. Spina bifida occulta was significantly associated with renal impairment and considered as a risk factor. Additionally, severe vesicoureteral reflux, hydronephrosis, and repeated febrile urinary tract infection were also significantly associated with renal impairment. Spina bifida occulta with lower urinary tract dysfunction was more frequently associated with renal impairment than spina bifida aperta. To prevent renal impairment, management of lower urinary tract function, including urinary state, is necessary while following up patients suffering from spina bifida with a high risk for renal impairment.
