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Baseline Urinary Imaging in Infants Enrolled in Urologic Management to Preserve Initial Renal Function (UMPIRE) Protocol for Children with Spina Bifida
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June 2019
Source: J Urol. 201(6):1193-1198
[PDF-80.57 KB]
Details:
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Alternative Title:J Urol
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Personal Author:
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Description:PURPOSE:
The lifetime risk of renal damage among children with spina bifida (SB) is high, but only limited baseline imaging data are available for this population. We therefore queried a large, prospective cohort of infants with SB to define their baseline imaging characteristics.
PATIENTS AND METHODS:
The Urologic Management to Preserve Initial Renal Function Protocol for Young Children with Spina Bifida (UMPIRE) is an iterative quality-improvement protocol that follows a cohort of newborns at nine US centers. Using descriptive statistics, we described the initial baseline imaging characteristics, specifically renal bladder ultrasound (RBUS), cystogram and DMSA scan.
RESULTS:
Data on 193 infants from 2015–2018 were analyzed. RBUS was normal in 55.9% of infants, while 40.4% of infants had Society for Fetal Urology (SFU) grade 1–2 hydronephrosis in at least one kidney, 3.7% of infants had SFU grade 3–4 hydronephrosis in either kidney, and 21.8% of infants had bilateral hydronephrosis (SFU grade 1 or higher). There was no vesicoureteral reflux in 84.6% of infants. Of the one third of enrolled infants who had a DMSA renal scan, 92.4% had no renal defects and 93.9% of infants had a difference in differential function of <15%.
CONCLUSIONS:
The majority of infants born with SB have normal baseline imaging characteristics and normal urinary tract anatomy at birth. This proactive protocol offers careful scheduled surveillance of the urinary tract with the goal of lifelong maintenance of normal renal function and healthy genitourinary development.
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Pubmed ID:30730412
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Pubmed Central ID:PMC6625656
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