To evaluate the incidence and age of onset of chronic kidney disease (CKD) and end-stage renal disease (ESRD) among pediatric patients with spina bifida, and to identify clinical factors associated with CKD in this population.
Approach:
Study Design: A population-based retrospective cohort study was conducted on patients born in Ontario, Canada, between April 1, 1992, and March 31, 2023.
Data Sources: Data were derived from the Institute for Clinical Evaluative Sciences (ICES), utilizing administrative databases for publicly insured individuals in Ontario.
Patient Identification: Patients with spina bifida were identified using diagnosis codes from multiple databases, with a control group of patients without spina bifida.
Outcome Measures: The primary outcome was the incidence rate of CKD, and secondary outcomes included long-term dialysis and kidney transplant rates.
Key Findings:
Approximately 34% to 50% of pediatric patients with spina bifida develop CKD, according to smaller studies.
Advanced chronic kidney disease (CKD) is twice as common in adults with spina bifida compared to those without, based on a large cohort study.
Adults with spina bifida are diagnosed with end-stage renal disease (ESRD) approximately 20 years earlier than those without, as indicated by previous research.
Interpretation:
The study highlights the need for longitudinal studies to clarify the onset of kidney disease in pediatric patients with spina bifida and to identify key predictors of kidney morbidity.
Limitations:
The study is retrospective and relies on administrative data, which may have limitations in accuracy.
Clinical predictors for kidney disease among patients with spina bifida have not been evaluated at the population level.
Conclusion:
There is a significant incidence of CKD among pediatric patients with spina bifida, necessitating further investigation into early identification and risk factors.
