Diagnostic Test Characteristics of Ultrasound-Based Hydronephrosis For Chronic Kidney Disease in Children and Adolescents With Myelomeningocele: Results From the UMPIRE and National Spina Bifida Patient Registry Cohort Studies.

Details

• Alternative Title:
  The Journal of Urology, 2025, v. 213, no. 3: Diagnostic Test Characteristics of Ultrasound-Based Hydronephrosis For Chronic Kidney Disease in Children and Adolescents With Myelomeningocele: Results From the UMPIRE and National Spina Bifida Patient Registry Cohort Studies.
• Journal Article:
  The Journal of Urology
• Personal Author:
  Chu, David I. ; Liu, Tiebin ; Williams, Tonya ; Mix, Jacqueline ; Ahn, Jennifer ; Austin, J. Christopher ; Baum, Michelle ; Clayton, Douglass ; Jarosz, Susan ; Joseph, David ; Roth, Elizabeth ; Routh, Jonathan ; Tu, Duong ; Vasquez, Evalynn ; Wallis, M. Chad ; Wiener, John ; Cheng, Earl ; Yerkes, Elizabeth ; Tanaka, Stacy
• Description:
  Renal ultrasounds are performed in patients with myelomeningocele to screen for markers of kidney health, including hydronephrosis. We evaluated the diagnostic accuracy of hydronephrosis to screen for low kidney function defined by estimated glomerular filtration rate (eGFR).
  
  We performed a retrospective cross-sectional study using data from 2 cohorts of children and youth with myelomeningocele. The first cohort is from UMPIRE (2016-2022) and the second from the National Spina Bifida Patient Registry (NSBPR; 2009-2021). We identified patients aged 1 to 18 years with available eGFR data within 6 months of an ultrasound. We excluded NSBPR patients younger than 6 years to address potential duplication across cohorts. The primary outcome was eGFR < 90 mL/min/1.73 m
  
  , calculated using the bedside Schwartz formula. Hydronephrosis was dichotomized into any/none. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of any hydronephrosis using eGFR as the reference standard.
  
  In UMPIRE, 221 patients were included with median age 2.4 years (IQR, 1.9-3.8) and 24% having eGFR < 90. Any hydronephrosis vs none conferred a sensitivity/specificity/PPV/NPV of 25%/75%/24%/77%, respectively. In NSBPR, 2269 patients were included with median age 13 years (IQR, 9.6-16.3) and 17% having eGFR < 90. Any hydronephrosis vs none conferred a sensitivity/specificity/PPV/NPV of 24%/87%/26%/85%, respectively.
  
  In 2 cohorts of children and youth with myelomeningocele, hydronephrosis conferred a sensitivity of ∼25% for a creatinine-based eGFR < 90 mL/min/1.73 m
  
  . This low sensitivity suggests that hydronephrosis alone is a poor screening marker of kidney health.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Hydronephrosis
  • Child
  • Adolescent
  • Female
  • Meningomyelocele
  • Male
  • Child, Preschool
  • Retrospective Studies
  • Registries
  More +
• Keywords:
  • hydronephrosis
  • chronic kidney disease
  • spina bifida
  • myelomeningocele
  • spinal dysraphism
• Source:
  The Journal of Urology, 2025, v. 213, no. 3
• DOI:
  https://doi.org/10.1097/JU.0000000000004342
• ISSN:
  0022-5347 ; 1527-3792
• Pubmed ID:
  39651652
• Pubmed Central ID:
  PMC11805662
• Document Type:
  Text
• Funding:
  U01 DD001273/DD/NCBDD CDC HHSUnited States/ ; U01 DD001284/DD/NCBDD CDC HHSUnited States/ ; U01 DD001268/DD/NCBDD CDC HHSUnited States/ ; U01 DD001093/DD/NCBDD CDC HHSUnited States/ ; U01 DD001239/DD/NCBDD CDC HHSUnited States/ ; U01 DD001057/DD/NCBDD CDC HHSUnited States/ ; U01 DD001275/DD/NCBDD CDC HHSUnited States/ ; CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01 DD001058/DD/NCBDD CDC HHSUnited States/ ; U01 DD001276/DD/NCBDD CDC HHSUnited States/ ; U01 DD001280/DD/NCBDD CDC HHSUnited States/ ; U01 DD001235/DD/NCBDD CDC HHSUnited States/ ; U01 DD001236/DD/NCBDD CDC HHSUnited States/ ; U01 DD001234/DD/NCBDD CDC HHSUnited States/ ; U01 DD001278/DD/NCBDD CDC HHSUnited States/ ; K23 DK125670/DK/NIDDK NIH HHSUnited States/ ; U01 DD001265/DD/NCBDD CDC HHSUnited States/ ; U01 DD001062/DD/NCBDD CDC HHSUnited States/ ; U01 DD001240/DD/NCBDD CDC HHSUnited States/ ; U01 DD001274/DD/NCBDD CDC HHSUnited States/ ; U01 DD001263/DD/NCBDD CDC HHSUnited States/ ; U01 DD001266/DD/NCBDD CDC HHSUnited States/ ; U01 DD001282/DD/NCBDD CDC HHSUnited States/ ; U01 DD001237/DD/NCBDD CDC HHSUnited States/ ; U01 DD001272/DD/NCBDD CDC HHSUnited States/ ; U01 DD001271/DD/NCBDD CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  341-349 (16 pdf pages)
• Volume:
  213
• Issue:
  3
• Download URL:
  https://stacks.cdc.gov/view/cdc/261871/cdc_261871_DS1.pdf
• File Type:
  [PDF - 174.29 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:a2266adafc3032b3f4b64b5007cb7851e56c55f5aaa6eb3774b424408cc9690e496b47324a34ce3e16a202e50e849852dd6c378b4e89d0a3bd91410d7b4b1fff