Renal failure in patients with neurogenic lower urinary tract dysfunction

Area of Science:

• Nephrology
• Neurology
• Urology

Background:

• Neurogenic lower urinary tract dysfunction (NLUTD) affects individuals with multiple sclerosis, paraplegia, and neural tube defects.
• NLUTD can lead to unsafe urine storage and voiding, increasing the risk of reflux nephropathy and renal failure.

Purpose of the Study:

• To quantify the risk of renal failure in patients with NLUTD.
• To compare renal failure risk in patients with multiple sclerosis, paraplegia, and neural tube defects against the general population.

Main Methods:

• Utilized the General Practice Research Database (GPRD) from 1994-1997.
• Included patients aged 10-69 with multiple sclerosis, paraplegia, or neural tube defects.
• Compared the prevalence of renal failure and renal replacement therapy in these groups versus the general population.

Main Results:

• Patients with paraplegia and neural tube defects exhibited a substantially increased risk of renal failure compared to the general population.
• No increased risk of renal failure was observed in patients with multiple sclerosis.
• The age-standardized prevalence of renal failure in the GPRD population (10-69 years) was 14 per 10,000.

Conclusions:

• Paraplegia and neural tube defects are associated with a significantly higher risk of renal failure.
• Further investigation is needed to understand the lack of observed increased renal failure risk in multiple sclerosis patients.
• Regular screening for renal impairment is recommended for all three patient groups to prevent renal failure.