Abstract General Information

Title

KIDNEY FUNCTION AND APPEARANCE OF URINARY TRACT IN ULTRASOUND AND VCUG IN CHILDREN WITH MMC AT INITIAL EVALUATION.

Introduction and objective

It is believed that children with MMC are born without kidney abnormalities which appears later on in course of neurogenic bladder. Recent studies shows that up to 60% of children with neurogenic bladder develops some degree of chronic kidney disease at the time of transition to adult care. Baseline evaluation of kidney function and appearance in ultrasoud and VCUG may reveal children at risk.

Method

Among 101 children born in our centre between 2004 and 2022 with MMC 60 had available data of kidney function, ultrasound examination and VCUG within first 3 months of life. Kidney function were evaluation according to creatinine level. During ultrasound examination significant hydronephrosis and bladder wall appearance were evaluated. Evaluation of VUR was done during VCUG study.

Results

Among 60 children MMC was diagnosed prenatally in 30 cases and 6 of them had performed prenatal closure of the congenital malformation. All of children have introduced CIC since birth. Only one child have increased level of creatinine comparing to normal ranges for the age. 16 (26%) children have significant hydronephrosis at least of one kidney, and bladder wall thickness was observed in 17 (28%). VUR was diagnosed in 14 (23%) cases.

Conclusion

Approximately 25% of children with neurogenic bladder due to MMC have significant abnormalities in ultrasound and/or VCUG at the initial evaluation during the first 3 months of life. This children may have increased risk of chronic kidney disease development and need to be treated proactively.