PD04-05 ASSESSMENT OF RENAL DETERIORATION AND ASSOCIATED RISK FACTORS IN PATIENTS WITH MULTIPLE SCLEROSIS AT MEDIAN FOLLOW-UP OF 81 MONTHS: IS EARLY TREATMENT OF DETRUSOR OVERACTIVITY WARRANTED?

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neurogenic Voiding Dysfunction I1 Apr 2018PD04-05 ASSESSMENT OF RENAL DETERIORATION AND ASSOCIATED RISK FACTORS IN PATIENTS WITH MULTIPLE SCLEROSIS AT MEDIAN FOLLOW-UP OF 81 MONTHS: IS EARLY TREATMENT OF DETRUSOR OVERACTIVITY WARRANTED? Nabeel Shakir, Arthi Satyanarayan, Jessica Eastman, and Gary Lemack Nabeel ShakirNabeel Shakir More articles by this author , Arthi SatyanarayanArthi Satyanarayan 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.2018.02.283AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal deterioration (RD) in patients with multiple sclerosis (MS) may occur via upper urinary tract damage due to neurogenic bladder (NGB), but its risk factors in this population are not well elucidated. We evaluated urodynamic study (UDS) predictors of RD in patients with MS at a tertiary referral center. METHODS We reviewed adult patients with MS presenting for evaluation of NGB, with either baseline serum creatinine (SCr) or renal ultrasound (US), from a prospectively maintained database, and excluded patients with baseline abnormal renal function. RD was defined as doubled SCr, new onset hydronephrosis, or renal atrophy on follow-up US. Demographic and UDS parameters were evaluated in multivariable models of RD. RESULTS From 1999-2016, 660 patients were evaluated, of whom 475 met inclusion criteria with a median follow-up of 81 months (Figure 1). SCr doubled in 8 patients, 4 had decline by US, and 1 by both (3%). 53 patients met less strict criteria of decrease in estimated glomerular filtration rate (eGFR) by ≥30% (Figure 2). 46 of 355 patients with UDS at initial visit, and 11 of 120 patients without UDS had RD by imaging or eGFR (p=0.3). Using the less rigid criterion, body mass index, urolithiasis and detrusor overactivity (DO) were associated with RD, with DO remaining associated on multivariable analysis. 11/355 patients had RD by either doubled Cr or imaging, with which only history of diabetes mellitus and urolithiasis were associated. CONCLUSIONS By strict criteria, the rate of renal deterioration in patients referred with NGB due to MS was low (3%) at intermediate-term follow-up, was similar whether or not patients underwent UDS, and was associated with medical comorbidities but not 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. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e79 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nabeel Shakir More articles by this author Arthi Satyanarayan 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 ...