Renal calculi in spinal cord-injured patient: Association with reflux, bladder stones, and foley catheter drainage

Abstract

Renal units associated with reflux in the spinal cord-injured (SCI) patient have a greater incidence of kidney stones developing than in the nonrefluxing units. It is logical to assume that SCI patients with persistent reflux and bladder stones treated with cystolitholapaxy would be at even higher risk for kidney stones developing. Of the 898 SCI patients studied (1, 793 renal units), in 14.8 percent kidney stones developed. Kidney stones occurred in 161 of 1,517 (10.6 %) of nonrefluxing units. Of the 276 renal units with reflux, in 104 (37.7%) an ipsilateral stone developed. Of the 198 patients in whom a kidney stone formed, 56.6 percent managed their bladder with a Foley catheter whereas only 28 percent of 700 patients in whom a stone did not form used a Foley catheter. On evaluating 261 patients (520 renal units) with bladder stones treated with cystolitholapaxy, 62.5 percent of these patients were managed with a Foley catheter. The association between cystolitholapaxy treatment, reflux, and the formation of kidney stones was (1) in 22 of 111 (19.8 %) refluxing units, an ipsilateral stone formed; (2) in 70 of 409 (17.1 %) units that were nonrefluxing, stones developed; and (3) overall, in 92 (17.7 %) renal units, kidney stone developed. We concluded that kidney stone development is significantly increased in the SCI patient with reflux and/or Foley catheter drainage. From these data cystolitholapaxy treatment in the presence of reflux does not appear to increase the development of kidney stones.