Abstract
Objective
To evaluate predictors of renal deterioration (RD) in patients with multiple sclerosis
(MS) at a tertiary referral center.
Methods
We reviewed adult patients with MS presenting for evaluation of lower urinary tract
symptoms, with baseline urodynamic study (UDS) and either serum creatinine (SCr) or
renal ultrasound, from a prospectively maintained database, and excluded patients
with abnormal renal function. RD was defined as doubled SCr, new hydronephrosis, or
renal atrophy on follow-up ultrasound. Demographic and UDS parameters were evaluated
in multivariable models of RD.
Results
From 1999 to 2016, 660 patients were evaluated, and 355 met criteria with median follow-up
of 79 months. SCr doubled in 8 patients, 4 had decline by renal ultrasound, and 1
by both (3%). Overall, 46 patients met less strict criteria of decrease in estimated
glomerular filtration rate by ≥30%. Using the less rigid criterion, detrusor overactivity
(DO) remained associated with RD on multivariable analysis. Eleven of 355 patients
had RD by either imaging or doubled Cr, with which only history of diabetes mellitus
and nephrolithiasis were associated.
Conclusion
By strict criteria, the rate of RD in patients with neurogenic bladder due to MS was
low (3%) at intermediate-term follow-up and was not associated with UDS parameters.
Using more liberal criteria, DO was associated with deterioration, suggesting that
study of the impact of more aggressive control of DO in this population may be warranted.
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Article info
Publication history
Published online: September 26, 2018
Accepted:
September 18,
2018
Received in revised form:
September 9,
2018
Received:
July 16,
2018
Footnotes
Conflicts of Interest: The authors declare that there is no conflict of interest.
Funding:This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
