PD02-04 variability in cystatin C and creatinine based equations for chronic kidney disease staging in adult spina bifida patients
Abstract
INTRODUCTION AND OBJECTIVE: Optimal urologic man- agement for infants with spina bi fi da remains unclear. Since the goal of early UDS is to identify those at risk for upper tract injury, the Urologic Management to Preserve Initial Renal Function (UMPIRE) protocol calls for routine urodynamics (UDS) by 3 months old and annually for 5 years. However, pediatric UDS can be fraught for patients and families. We evaluate the utility of routine UDS in this retrospective study of children with spina bi fi da. METHODS: We included all infants with lipo- or myelome- ningocele from 2015 - 2020. We recorded all ultrasound, voiding cys-tourethrogram (VCUG), and UDS results from birth to 3 years old per the UMPIRE protocol. Given poor inter-rater reliability in reading detrusor sphincter dyssynergia, we de fi ned hostility on UDS as an end fi ll pressure > 40 cm H 2 O in the absence of a detrusor contraction. Upper tract changes (UTC) were de fi ned as any bilateral increase of (cid:3) 1 in Society of Fetal Urology (SFU) grade or unilateral increase of (cid:3) 2 in grade on either ultrasound or VCUG. Urinary tract infection (UTI) was de fi ned as symptoms (fever or lower urinary tract symptoms), > 100,000 cfu/mL of a single organism and > 10 WBCs/ hpf. We then determined if hostile UDS fi ndings preceded UTC or UTI from birth to 3 years old. Fisher's exact test was used to test the association between hostility on UDS and UTC or UTI. RESULTS: Twenty-seven infants were included; demographic,…
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