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Title: | Characteristics and predictors of chronic kidney disease in children with myelomeningocele: a nationwide cohort study | Authors: | Doğan, Çagla Serpil Taner, Sevgin Durucu Tiryaki, Betül Alaygut, Demet Özkayın, Neşe Kara, Aslıhan Gencler, Aylin Pınarbaşı, Ayşe Seda Nalçacıoğlu, Hülya Yüksel, Selçuk Akacı, Okan Yılmaz, Esra Karabağ Yavuz, Sevgi Doğan, Kenan Gülşan, Rumeysa Yasemin Çiçek Aksoy, Gülşah Kaya Çiçek, Neslihan Aksu, Bağdagül Küçük, Nuran Altugan, Fatma Şemsa Selçuk, Şenay Zırhlı Baştuğ, Funda Erfidan, Gökçen Atmış, Bahriye Gökçeoğlu, Arife Uslu Önder, Esra Nagehan Akyol Elmacı, Ahmet Mithat Cengiz, Nurcan Gülleroğlu, Kaan Yılmaz, Ebru Bekiroğlu Tayfur, Aslı Çelebi Yılmaz, Gülsün Gülay Yel, Sİbel Pehlivanoğlu, Cemile Kara, Mehtap Akbalık Kılıç, Beltinge Demircioğlu Şimşek, Özgür Özdemir Yucal, Melike Ağar, Buket Esen Gürgöze, Metin Kaya Yağmur, İsmail Madsar, Ömer Karalı, Demet Tekcan Girişgen, İlknur Bodur, Ece Demirci Çomak, Elif Gökçe, İbrahim Kaya, Mehtap Tabel, Yılmaz Günay, Neslihan Gülmez, Rüveyda Çalışkan, Salim |
Keywords: | Child Myelomeningocele Neurogenic bladder Predictors Chronic kidney disease Spina-Bifida Neurogenic Bladder Renal-Function Management Adolescents |
Publisher: | Springer | Abstract: | Background Myelomeningocele (MMC) is highly prevalent in developing countries, and MMC-related neurogenic bladder is an important cause of childhood chronic kidney disease (CKD). This nationwide study aimed to evaluate demographic and clinical features of pediatric patients with MMC in Turkey and risk factors associated with CKD stage 5.Methods Data from children aged 0-19 years old, living with MMC in 2022, were retrospectively collected from 27 pediatric nephrology centers. Patients > 1 year of age without pre-existing kidney abnormalities were divided into five groups according to eGFR; CKD stages 1-5. Patients on dialysis, kidney transplant recipients, and those with eGFR < 15 ml/min/1.73 m2 but not on kidney replacement therapy at time of study constituted the CKD stage 5 group.Results A total of 911 (57.8% female) patients were enrolled, most of whom were expectantly managed. Stages 1-4 CKD were found in 34.3%, 4.2%, 4.1%, and 2.4%, respectively. CKD stage 5 was observed in 5.3% of patients at median 13 years old (range 2-18 years). Current age, age at first abnormal DMSA scan, moderate-to-severe trabeculated bladder on US and/or VCUG, and VUR history were independent risk factors for development of CKD stage 5 (OR 0.752; 95%; CI 0.658-0.859; p < 0.001; OR 1.187; 95% CI 1.031-1.367; p = 0.017; OR 10.031; 95% CI 2.210-45.544; p = 0.003; OR 2.722; 95% CI 1.215-6.102; p = 0.015, respectively). Only eight CKD stage 5 patients underwent surgery related to a hostile bladder between 1 and 15 years old.Conclusion MMC-related CKD is common in childhood in Turkey. A proactive approach to neurogenic bladder management and early protective surgery in selected cases where conservative treatment has failed should be implemented to prevent progressive kidney failure in the pediatric MMC population in our country. | URI: | https://doi.org/10.1007/s00467-023-06212-5 https://hdl.handle.net/11499/56294 |
ISSN: | 0931-041X 1432-198X |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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