Article Text

RENAL INVOLVEMENT IN CHILDREN WITH SPINA BIFIDA
  1. J A Kari1,
  2. R Jamjoom1,
  3. O Safder1
  1. 1Department of Pediatrics, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia

Abstract

Renal scarring and renal failure remain life-threatening for children born with spinal dysraphism. An early start of therapy helps to safeguard renal function for such children. However, optimal care is not always available in developing countries.

We reviewed our data on all newborns with spina bifida who were born at King Abdulaziz University Hospital between 1997 and 2006.

Data on 33 children with myelomeningocele were evaluated. The mean ± SD age at the time of evaluation was 5.4 ± 2.3 years. 90% (30) were diagnosed as neurogenic bladder and 26 patients were diagnosed to have vesico-ureteral reflux (VUR). Only eight patients (group A) were receiving clean intermittent catheterisation (CIC), whereas the rest (group B) were either non-compliants or were not commenced on it. The mean number of urinary tract infections (UTI) was 4.5 ± 3.8. Patients who received CIC had a lower number of UTI (mean per year) 3.3 ± 1.2 compared with 6.6 ± 2.3. 62% of group A had VUR compared with 93% in group B. One patient progressed to chronic renal failure at 6 years of age. 12 patients had evidence of renal scars. Seven patients were lost to follow-up in our hospital.

Conclusion We have shown that the lack of an early therapy led to a considerable morbidity at a young age in children born with spina bifida. There is a need for more awareness about the importance of starting proactive treatment of risks for upper tract deterioration in babies with spina bifida.

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