It was believed that neurogenic bladder (NB) might be a risk factor of chronic kidney disease (CKD). However, data are limited regarding the real incidence or risk of CKD in NB. In addition, serum creatinine (sCr), a classical marker of renal function, is not reliable in NB patients because they present muscle wasting due to disuse or denervation. The aim of the study was to estimate the prevalence of CKD in NB patients using serum Cystatin-C. Secondly, we aimed to identify the risk factors for CKD development in NB.
This was a cross-sectional study in a public hospital, a specialized center for patients who were victims of industrial accidents. Serum Cystatin-C was checked at the regular laboratory test in the structured NB program of the hospital, and 313 patients were included in the study.
The overall prevalence of CKD, defined as estimated glomerular filtration rate (eGFR) <60/ml/1.73 m(2) was 8.0% and 22.4%, by sCr-based and Cystain-C-based eGFR, respectively, and was greater than age-matched general population in Korea. sCr was not able to detect the early deterioration of renal function in NB patients. Co-morbid diabetes, small bladder volume, recurrent UTI, and proteinuria were significantly associated with CKD in the multivariable analysis.
CKD prevalence was more than 3 times higher in NB patients than in the general population despite recent progress in the medical care of NB. Co-morbid diabetes, small bladder volume, recurrent UTI, and proteinuria seem to be the risk factors for CKD development in NB. This article is protected by copyright. All rights reserved.
Nephrology (Carlton, Vic.). 2016 Dec 30 [Epub ahead of print]
Bong Mo Sung, Dong-Jin Oh, Moon Hee Choi, Hye Min Choi
Department of Urology, Korea Workers' Compensation & Welfare Hospital, Incheon, South Korea., Department of Internal Medicine, Seonam University Myongji Hospital, Goyang, Gyeonggi-do., Department of Laboratory Medicine, Korea Workers' Compensation & Welfare Hospital, Incheon, South Korea.