OBJECTIVES: We evaluated the association between chronic kidney disease and the current and background conditions of adults with spina bifida. METHODS: Patients with spina bifida (group A, n = 34) and patients with a history of pediatric encephalitis or spinal cord injury (group B, n = 23) who were older than 18 years between January 2013 and August 2022 were retrospectively analyzed. The chronic kidney disease-free survival was compared between groups. In each group, the congenital or pediatric background conditions (gender, disease type, history of febrile urinary tract infection, bladder augmentation, vesico-ureteral reflux, or detrusor overactivity) and current background conditions (age at last follow-up, ambulatory status, hypertension, and albuminuria) were compared between patients with or without chronic kidney disease. RESULTS: The median age was 37 years (range 20-67 years). The median chronic kidney disease-free survival was younger in group A than group B (48.0 vs. 65.0 years, p = 0.0027). In group A, chronic kidney disease was associated with pediatric febrile urinary tract infection (p = 0.0018) and vesico-ureteral reflux (p = 0.0090), current hypertension (p < 0.001), and albuminuria (p = 0.0053). Multivariate analysis showed only hypertension was significantly associated with chronic kidney disease. CONCLUSION: Young to middle-aged adults with spina bifida with a history of pediatric febrile urinary tract infection or vesico-ureteral reflux and those with current hypertension or albuminuria have an increased risk of chronic kidney disease, suggesting the need for renal function monitoring.