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High EDSS can predict risk for upper urinary tract damage in patients with multiple sclerosis
Benjamin V Ineichen1, Marc P Schneider2, Martin Hlavica3
1Brain Research Institute, University of Zürich and Department of Health Sciences and Technology, Swiss Federal Institute of Technology Zürich, Zürich, Switzerland/Department of Neurology, University Hospital Zürich, Zürich, Switzerland.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|April 4, 2017
Summary
The Expanded Disability Status Scale (EDSS) can predict upper urinary tract damage in multiple sclerosis (MS) patients. A high EDSS score indicates a greater risk, aiding in early neuro-urological assessment and treatment.
Area of Science:
- Neuroscience
- Urology
- Clinical Medicine
Background:
- Neurogenic lower urinary tract dysfunction (NLUTD) is prevalent in multiple sclerosis (MS) and can impair renal function and increase mortality.
- While urodynamic risk factors for upper urinary tract damage are known, clinical predictors are lacking.
Purpose of the Study:
- To identify clinical parameters that predict urodynamic risk factors for upper urinary tract damage in MS patients.
- To establish a clinical tool for risk stratification in MS-related neurogenic bladder.
Main Methods:
- Prospective evaluation of 141 MS patients undergoing neuro-urological work-up with urodynamics.
- Assessment of clinical parameters including age, sex, MS duration/course, and Expanded Disability Status Scale (EDSS).
Main Results:
- The EDSS was significantly associated with urodynamic risk factors for upper urinary tract damage (OR = 1.34, p = 0.02).
- An EDSS cutoff of 5.0 demonstrated 86%-87% sensitivity and 52% specificity for identifying at least one risk factor.
Conclusions:
- Elevated EDSS scores are linked to increased risk of upper urinary tract damage in MS patients.
- EDSS facilitates risk-stratified clinical practice, identifying MS patients needing further neuro-urological evaluation.