Risk Factors for Renal Function Impairment in Childen with Meningomyelocele; a Single Center Study

Chronic kidney disease and its complications are among the most frequent cause of morbidity andmortality in patients with meningomyelocele.Objective: In this study, we aimed to determine the risk factors leading to chronic kidney disease progression inthese patients.Material and Method: Fifty patients with meningomyelocele were analyzed retrospectively. Age, gender, followup period, serum creatinine, glomerular filtration rate, vesicoureteral reflux (VUR), initial urodynamic findings andinitiation time of clean intermittent catheterization (CIC) were noted. The progression of Chronic kidney disease(CKD) was evaluated by DMSA renal scintigraphy, changes in serum creatinine (Screa), and glomerular filtrationrate (GFR).Results: 30 of the 50 patients were included in the study. VUR was detected in 63% of the patients, and scar wasdetected in 83% by renal scintigraphy. The median value of Screa was 0.5 mg/dl in admission, while the medianScrea was 1.02 mg/dl (min-max: 0.27-5) at the last visit and the difference was statistically significant (p=0.001).A statistically significant was found between CKD progression and GFR in admission (p=0.001), CIC onset age(p=0.03), degree of VUR (p=0.046), presence of renal scar (p=0.002). It was shown that delay in admission(p=0.011; OR 1.36; CI 1.07-1.73) and low GFR in admission (p=0.036 OR 0.915 CI 0.842-0.994) were the mostimportant risk factors.Conclusion: In our study, it was shown that delay in neurogenic bladder treatment, delay in the initiation of CIC, andlow GFR at admission were important risk factors for the progression of CKD in children with meningomyelocele.Therefore, we aimed to emphasize the importance of regular follow-up of these children in Pediatric NephrologyClinics from the neonatal period.