E Braley-Berthoumieux1, X Gamé2, P Marque1, X de Boissezon1, P Rischmann2, E Castel-Lacanal3. 1. Service de médecine physique et de réadaptation, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 1, France. 2. Département d'urologie et de transplantation rénale et d'andrologie, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 2, France. 3. Service de médecine physique et de réadaptation, centre hospitalier universitaire Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse 1, France. Electronic address: c_evelyne@yahoo.com.
Abstract
OBJECTIVES: The assessment of renal function is essential to follow up the patients with neurogenic bladder. The objective of this study was to determine if renal ultrasonography would both evaluate the morphology of the urinary tract and renal function. METHOD: In a retrospective study, all patients followed for neurogenic bladder were included, regardless of their neurological disease. Renal function was estimated by creatinine clearance (Cl24 h), the reference test in neurological patients, the glomerular filtration rate by the MDRD simplified (MDRDs) and CKD-EPI creatinine formula, and we identified renal abnormalities detected on ultrasonography. RESULTS: One hundred and three patients were included (57 men-36 women), mean age 51±13 years. Fifty-nine patients had multiple sclerosis, 23 spinal cord injury. Depending on the method used (Cl24h, MDRDs, CKD-EPI creatinine) respectively 54, 49 and 39 patients had abnormal renal function; eleven patients had abnormal findings on renal ultrasonography. The sensitivity of ultrasonography as an indirect indicator of renal function depending on the method used (Cl24h, MDRDs, CKD-EPI creatinine) was equal respectively to 14%, 8% and 10%. CONCLUSION: Renal ultrasonography, which is essential to follow up the neurogenic bladder, is not enough sensitive to detect abnormal renal function and should continue to be associated with an evaluation of renal function, which is suitable for neurological patients. LEVEL OF EVIDENCE: 4.
OBJECTIVES: The assessment of renal function is essential to follow up the patients with neurogenic bladder. The objective of this study was to determine if renal ultrasonography would both evaluate the morphology of the urinary tract and renal function. METHOD: In a retrospective study, all patients followed for neurogenic bladder were included, regardless of their neurological disease. Renal function was estimated by creatinine clearance (Cl24 h), the reference test in neurologicalpatients, the glomerular filtration rate by the MDRD simplified (MDRDs) and CKD-EPI creatinine formula, and we identified renal abnormalities detected on ultrasonography. RESULTS: One hundred and three patients were included (57 men-36 women), mean age 51±13 years. Fifty-nine patients had multiple sclerosis, 23 spinal cord injury. Depending on the method used (Cl24h, MDRDs, CKD-EPI creatinine) respectively 54, 49 and 39 patients had abnormal renal function; eleven patients had abnormal findings on renal ultrasonography. The sensitivity of ultrasonography as an indirect indicator of renal function depending on the method used (Cl24h, MDRDs, CKD-EPI creatinine) was equal respectively to 14%, 8% and 10%. CONCLUSION: Renal ultrasonography, which is essential to follow up the neurogenic bladder, is not enough sensitive to detect abnormal renal function and should continue to be associated with an evaluation of renal function, which is suitable for neurologicalpatients. LEVEL OF EVIDENCE: 4.