Renal scarring in spinal cord injury: a progressive process?

A retrospective analysis.

To examine the natural history of renal scarring in the spinal cord injured population.

United Kingdom.

All spinal cord injured patients with renal scars at our establishment were considered eligible. A total of 27 patients with renal scars were identified. No patient had renal scarring at presentation on radiological imaging. All patients had annual renal imaging with a mean follow up period of 19.1 years. The presence of new scars was considered as evidence of progression.

In all, 59% of kidneys developed renal scars with a mean time interval between spinal injury and renal scar development of 13 years. Of these kidneys with scars, only 15.6% demonstrated progression of the scarring process. There were no deaths due to renal causes.

The aetiology of renal scarring is multifactorial. The findings of this study suggest that renal scarring in the spinal cord injured population is predominantly a nonprogressive process once a scar has developed. This is in concordance with the belief that renal scarring in the paediatric population with vesicoureteric reflux is also a stable, nonprogressive process.