Stacy T Tanaka1, Pangaja Paramsothy2, Judy Thibadeau2, John S Wiener3, David B Joseph4, Earl Y Cheng5, Duong Tu6, Christopher Austin7, Chester J Koh6, M Chad Wallis8, William O Walker9, Kathryn A Smith10, Jonathan C Routh3, Michelle A Baum10. 1. Division of Pediatric Urology, Monroe Carell Jr. Children's Hospital at Vanderbilt , Nashville , Tennessee. 2. Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention , Atlanta , Georgia. 3. Division of Urology, Duke University Medical Center , Durham , North Carolina. 4. Department of Urology, University of Alabama-Birmingham , Birmingham , Alabama. 5. Division of Urology, Lurie Children's Hospital of Chicago , Chicago , Illinois. 6. Division of Urology, Texas Children's Hospital/Baylor College of Medicine , Houston , Texas. 7. Department of Urology, Oregon Health Sciences University , Portland , Oregon. 8. Division of Urology, Primary Children's Hospital , Salt Lake City , Utah. 9. Division of Developmental Medicine, Seattle Children's Hospital , Seattle , Washington. 10. Division of General Pediatrics, Children's Hospital Los Angeles , Los Angeles , California.
Abstract
PURPOSE: The lifetime risk of renal damage in children with spina bifida is high but only limited baseline imaging data are available for this population. We evaluated a large prospective cohort of infants with spina bifida to define their baseline imaging characteristics. MATERIALS AND METHODS: The UMPIRE Protocol for Young Children with Spina Bifida is an iterative quality improvement protocol that follows a cohort of newborns at 9 United States centers. Using descriptive statistics, we report the initial baseline imaging characteristics, specifically regarding renal bladder ultrasound, cystogram and dimercaptosuccinic acid nuclear medicine scan. RESULTS: Data on 193 infants from 2015 to 2018 were analyzed. Renal-bladder ultrasound was normal in 55.9% of infants, while 40.4% had Society for Fetal Urology grade 1 to 2 hydronephrosis in at least 1 kidney, 3.7% had grade 3 to 4 hydronephrosis in either kidney and 21.8% had grade 1 or higher bilateral hydronephrosis. There was no vesicoureteral reflux in 84.6% of infants. A third of enrolled infants underwent dimercaptosuccinic acid nuclear medicine renal scan, of whom 92.4% had no renal defects and 93.9% had a difference in differential function of less than 15%. CONCLUSIONS: The majority of infants born with spina bifida 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.
PURPOSE: The lifetime risk of renal damage in children with spina bifida is high but only limited baseline imaging data are available for this population. We evaluated a large prospective cohort of infants with spina bifida to define their baseline imaging characteristics. MATERIALS AND METHODS: The UMPIRE Protocol for Young Children with Spina Bifida is an iterative quality improvement protocol that follows a cohort of newborns at 9 United States centers. Using descriptive statistics, we report the initial baseline imaging characteristics, specifically regarding renal bladder ultrasound, cystogram and dimercaptosuccinic acid nuclear medicine scan. RESULTS: Data on 193 infants from 2015 to 2018 were analyzed. Renal-bladder ultrasound was normal in 55.9% of infants, while 40.4% had Society for Fetal Urology grade 1 to 2 hydronephrosis in at least 1 kidney, 3.7% had grade 3 to 4 hydronephrosis in either kidney and 21.8% had grade 1 or higher bilateral hydronephrosis. There was no vesicoureteral reflux in 84.6% of infants. A third of enrolled infants underwent dimercaptosuccinic acid nuclear medicine renal scan, of whom 92.4% had no renal defects and 93.9% had a difference in differential function of less than 15%. CONCLUSIONS: The majority of infants born with spina bifida 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.
Authors: Tiebin Liu; Lijing Ouyang; Judy Thibadeau; John S Wiener; Jonathan C Routh; Heidi Castillo; Jonathan Castillo; Kurt A Freeman; Kathleen J Sawin; Kathryn Smith; Alexander Van Speybroeck; Rodolfo Valdez Journal: J Urol Date: 2017-11-11 Impact factor: 7.450
Authors: Meera Viswanathan; Katherine A Treiman; Julia Kish-Doto; Jennifer C Middleton; Emmanuel J L Coker-Schwimmer; Wanda K Nicholson Journal: JAMA Date: 2017-01-10 Impact factor: 56.272
Authors: Cristian Sager; Carol Burek; Juan Pablo Corbetta; Santiago Weller; Javier Ruiz; Ramiro Perea; Enrique Lago; Yesica Gomez; Victor Durán; Juan Carlos López Journal: J Pediatr Urol Date: 2017-01-30 Impact factor: 1.830
Authors: S B Bauer; M Hallett; S Khoshbin; R L Lebowitz; K R Winston; S Gibson; A H Colodny; A B Retik Journal: JAMA Date: 1984-08-03 Impact factor: 56.272
Authors: Paul W Veenboer; Monique G G Hobbelink; J L H Ruud Bosch; Pieter Dik; Floris W A van Asbeck; Frederik J A Beek; Laetitia M O de Kort Journal: Neurourol Urodyn Date: 2014-04-07 Impact factor: 2.696
Authors: Jonathan C Routh; Earl Y Cheng; J Christopher Austin; Michelle A Baum; Patricio C Gargollo; Richard W Grady; Adrienne R Herron; Steven S Kim; Shelly J King; Chester J Koh; Pangaja Paramsothy; Lisa Raman; Michael S Schechter; Kathryn A Smith; Stacy T Tanaka; Judy K Thibadeau; William O Walker; M Chad Wallis; John S Wiener; David B Joseph Journal: J Urol Date: 2016-07-27 Impact factor: 7.450
Authors: James T Rague; Jeremy D Lai; Peggy Murphy; Andrea Fawcett; Ryan Walton; Ilina Rosoklija; Diana K Bowen; Elizabeth B Yerkes; Earl Y Cheng; Kavita S Hodgkins; Jonathan C Routh; Tamara Isakova; David I Chu Journal: J Urol Date: 2022-01-20 Impact factor: 7.600
Authors: David I Chu; Lauren C Balmert; Liqi Chen; Cameron Arkin; Theresa Meyer; Ilina Rosoklija; Diana K Bowen; Kavita S Hodgkins; Robin M Bowman; Earl Y Cheng; Elizabeth B Yerkes; Tamara Isakova Journal: J Urol Date: 2020-11-18 Impact factor: 7.450
Authors: M Chad Wallis; Pangaja Paramsothy; Kimberly Newsome; Tonya Williams; Jonathan C Routh; David B Joseph; Earl Cheng; Duong Tu; J Chris Austin; Stacy T Tanaka; William O Walker; Kathryn A Smith; Michelle A Baum; John S Wiener Journal: J Urol Date: 2021-03-08 Impact factor: 7.600