PD04-10 DEMOGRAPHIC AND URODYNAMIC RISK ANALYSIS OF RENAL DETERIORATION IN SPINAL CORD INJURED PATIENTS

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction I1 Apr 2018PD04-10 DEMOGRAPHIC AND URODYNAMIC RISK ANALYSIS OF RENAL DETERIORATION IN SPINAL CORD INJURED PATIENTS Arthi Satyanarayan, Nabeel Shakir, Jessica Eastman, and Gary Lemack Arthi SatyanarayanArthi Satyanarayan More articles by this author , Nabeel ShakirNabeel Shakir More articles by this author , Jessica EastmanJessica Eastman More articles by this author , and Gary LemackGary Lemack More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.288AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Though the risk of progressive renal insufficiency in patients with spinal cord injury (SCI) has decreased over the past several decades, it is clear that certain patients remain at risk. The purpose of this study was to assess predictors of renal deterioration in patients with SCI. METHODS We reviewed renal status in adult SCI patients from August 2001 to May 2015 after recovery from spinal shock using a prospectively maintained database. Patients with baseline renal ultrasound and/or serum creatinine (SCr) followed by urodynamic study (UDS) were included. Those with baseline abnormal renal function or no follow-up were excluded. Renal deterioration was defined as doubled SCr, 30% or more decrease in the estimated glomerular filtration rate (eGFR), new hydronephrosis, or renal atrophy. Demographic and UDS parameters were assessed in univariate and multivariable regression models to determine association with renal deterioration. RESULTS 98 patients met study criteria with median follow-up of 43 months.13/98 (13%) experienced renal deterioration: 9 by eGFR, 3 by imaging and 1 by both (Figure 1). Demographic factors and UDS parameters were not associated with renal deterioration (Table 1). 15 patients had altered compliance and were managed by indwelling catheter (3), intermittent catheterization (11), or spontaneous voiding (1). Patients with renal loss were not more likely to have altered compliance compared to those without (1/13 vs 14/87, p=0.7). CONCLUSIONS In SCI patients at a tertiary neurourology clinic, the rate of renal deterioration is modest, without associated demographic or urodynamic predictors. Though untreated intravesical pressure elevation may predict renal deterioration in SCI, our series suggests patients can maintain normal renal function given appropriate bladder management. Nonetheless, ongoing surveillance is recommended given that renal loss occurs, albeit at an improved rate compared to historical series. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e81 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Arthi Satyanarayan More articles by this author Nabeel Shakir More articles by this author Jessica Eastman More articles by this author Gary Lemack More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...