Pd55-07 Long-Term Renal Outcomes in Adult Classic Bladder Exstrophy Patients

You have accessJournal of UrologyPediatrics VI (PD55)1 May 2024PD55-07 LONG-TERM RENAL OUTCOMES IN ADULT CLASSIC BLADDER EXSTROPHY PATIENTS Alexander M. Hirsch, Ahmad Haffar, Victoria Maxon, Logan Galansky, Christian C. Morrill, Chad Crigger, John P. Gearhart, and Heather N. Di Carlo Alexander M. HirschAlexander M. Hirsch , Ahmad HaffarAhmad Haffar , Victoria MaxonVictoria Maxon , Logan GalanskyLogan Galansky , Christian C. MorrillChristian C. Morrill , Chad CriggerChad Crigger , John P. GearhartJohn P. Gearhart , and Heather N. Di CarloHeather N. Di Carlo View All Author Informationhttps://doi.org/10.1097/01.JU.0001008908.82706.9f.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients born with classic bladder exstrophy (CBE) are at increased risk of renal dysfunction. The authors seek to investigate the prevalence of chronic kidney disease (CKD) in this population. METHODS: A prospectively maintained database of 1505 exstrophy-epispadias patients was reviewed for exstrophy closure events and related renal function data. Patients diagnosed with CBE who had at least one recorded serum creatinine value after 18 years of age, recorded before July 1, 2023, were included. Estimated glomerular flow rate (eGFR) was calculated using serum creatinine via the CKD-EPI Creatinine Equation (2021) on two serum measurements at least 3 months apart. RESULTS: Two hundred sixty-five patients (181 males), median age 35.5 (interquartile range [IQR] 27.8 – 44.3), were included. Forty-seven percent (125/265) were closed primarily using the modern staged repair of exstrophy (MSRE) technique. Thirty percent (78/265) required reclosure due to failed primary closure. Of the total cohort, 10.2% (27/265) had CKD stage 3 or greater, with a median age at diagnosis of 41.0 years. Primary closure technique did not affect mean eGFR (p=0.27) or rates of CKD stage 3 or greater (p=0.54). Patients who required reclosure after failed primary closure were significantly less likely to progress to CKD stage 3 (3.9% vs. 15.1%, p=0.011) overall, but progressed to stage 3 at an earlier age (mean age 26.9 years [SD +/- 1.3] vs. 41.4 years [SD +/- 17.5]). CONCLUSIONS: CKD is a significant problem among patients born with CBE. Patients who experienced failure of primary closure and required reclosure developed CKD at a significantly earlier age than those with successful primary closure. This finding juxtaposes frequency of follow up and outcomes – failed closure and less risk of CKD vs. successful primary closure and worse renal outcomes. This further supports the close follow up of all CBE patients by a nephrologist familiar with the condition to protect renal function later into adulthood. Source of Funding: This project did not receive support from any external funding sources © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1152 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alexander M. Hirsch More articles by this author Ahmad Haffar More articles by this author Victoria Maxon More articles by this author Logan Galansky More articles by this author Christian C. Morrill More articles by this author Chad Crigger More articles by this author John P. Gearhart More articles by this author Heather N. Di Carlo More articles by this author Expand All Advertisement PDF downloadLoading ...