Investi̇gati̇on of the Frequency of Vesi̇coureteral Reflux (Vur) and the Effect of Regular Follow-up on the Progressi̇on to End-stage Renal Di̇sease İn Pati̇ents Wi̇th Spi̇na Bi̇fi̇da

Objective In this study, we aimed to investigate the frequency of vesicoureteral reflux (VUR) in patients with spina bifida and neurogenic bladder, as well as the effect of regular follow-up and clean intermittent catheterization (CIC) on the progression to end-stage renal disease (ESRD). Materials and Methods The study was conducted retrospectively by reviewing the medical records of patients with a diagnosis of spina bifida followed up and treated in our hospital’s Pediatric Surgery clinic. The patients' medical files were examined for biochemical urea-creatinine values, radiological voiding cystourethrography (VCUG) results, static renal scintigraphy (DMSA) results, urodynamic findings, initiated and ongoing treatments, and surgical interventions. Results A total of 236 patients diagnosed with spina bifida were included in the study. According to VCUG results, 34.7% of the patients had vesicoureteral reflux. 13.1% of the patients had chronic kidney disease (CKD). Among those with CKD, 45.2% were regularly followed up, while 95.1% of those without CKD were regularly followed up. A statistically significant difference was found between the two groups regarding regular follow-up (X2 = 66.340; p < 0.001). The regular follow-up rate was lower in patients with CKD compared to those without CKD. In addition, 32.3% of the CKD patients and 88.8% of the non-CKD patients received regular CIC. A statistically significant difference was also found between the two groups regarding regular CIC application (X2 = 56.717; p < 0.001). The regular CIC rate was lower in patients with CKD compared to those without CKD. Conclusion Our study suggests that regular follow-up and clean intermittent catheterization (CIC) in patients with spina bifida can reduce the progression to chronic kidney disease compared to those who do not undergo regular follow-up or CIC. Initiating CIC at an appropriate time from the neonatal period can prevent nephrological/urological complications and, consequently, the progression to chronic kidney disease.