FP291NEUROGENIC BLADDER AND CHRONIC KIDNEY DISEASE IN SPINCAL CORD INJURY PATIENTS

Abstract

Introduction and Aims: It is believed that patients with neurogenic bladder (NB) have a significantly higher risk of developing chronic kidney disease (CKD) than the general population.However, data are limited except a few studies that examined the incidence of renal failure in spina bifida ormyelomeningocele in pediatric patients. In addition, serum creatinine is not a reliable marker for renal function inNB patients because they present musclewasting due to disuse or denervation.We examined the prevalence of CKDinNB patients fromspinal cord injury using serum cystatin-C, and the risk factors for progression to CKD. Method(s):Thiswas across sectional study inKoreaworkers' compensation &welfare Hospital, which is a specialized center for patients fromindustrial accident. Patients withNB were under regular examination including regular laboratory test and urologic study such as urodynamic study, Sonography and voiding cystourethrography. Patients who visited urology department for routine check-up underwent additionalmeasurement of serumcystatin-C for 3mo. Result(s): Serum cystatin-C was checked in 314 patients (mean age 58.1+/-8.8 yr, mean time period after injury 18.9+/-9.3yr).Detrusor hyperreflexia and areflexia accounted for 66.0% and 22.2%, respectively. The overall prevalence of CKD, defined as estimated glomerular filtration rate (eGFR) < 60ml/min/1.73m2 was 22.4% and 8.0%by cystatin-C and creatinine-based CKD-EPI equation, respectively, and was greater than in age-matched general population (KoreanNationalHealth andNutritional Examination Surveys). Initial eGFR, co-morbid diabetes, proteinuria, bladder volume and the presence of recurrent urinary tract infection (UTI) were the independent risk factors for CKD development in themultivariable analysis while different bladder emptyingmodalities was not significantly associated. Conclusion(s): The prevalence of CKD is higher in NB patients than in the general population and cystatin-C was more sensitive than creatinine for detecting CKD in NB patients. Co-morbid diabetes, proteinuria, bladder volume and the presence of recurrent UTI seem to be the important risk factors for development of CKD in NB patients.