Assessment of Renal Deterioration and Associated Risk Factors in Patients With Multiple Sclerosis

Nabeel A. Shakir, Arthi Satyanarayan, Jessica Eastman, Benjamin Greenberg, Gary E Lemack

Research output: Contribution to journalArticle

1 Citation (Scopus)

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.

Original languageEnglish (US)
JournalUrology
DOIs
StateAccepted/In press - Jan 1 2018

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Multiple Sclerosis
Kidney
Urodynamics
Creatinine
Serum
Nephrolithiasis
Neurogenic Urinary Bladder
Lower Urinary Tract Symptoms
Hydronephrosis
Glomerular Filtration Rate
Tertiary Care Centers
Atrophy
Diabetes Mellitus
Demography
Databases
Population

ASJC Scopus subject areas

  • Urology

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Assessment of Renal Deterioration and Associated Risk Factors in Patients With Multiple Sclerosis. / Shakir, Nabeel A.; Satyanarayan, Arthi; Eastman, Jessica; Greenberg, Benjamin; Lemack, Gary E.

In: Urology, 01.01.2018.

Research output: Contribution to journalArticle

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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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