title: Renal deterioration in multiple sclerosis patients with neurovesical dysfunction.
abstract: OBJECTIVE
  Our aims were to determine the prevalence of renal ultrasound (RUS) abnormalities over time in multiple sclerosis (MS) patients with lower urinary tract symptoms (LUTS).
  
  
  METHODS
  Data were examined retrospectively from MS patients with LUTS, from 2000-2009. Study inclusion requirements were both baseline urodynamics (UD) and RUS data, with followup RUS at ≥ 12 months. Age, time since diagnosis (TSD), MS subtype and the UD/RUS results were evaluated for associations.
  
  
  RESULTS
  At presentation, 173 subjects underwent UD and RUS, but only 89 had a repeat RUS at ≥ 12 months. Median followup was 61 months. Initial RUS abnormalities were found in 10 (5.8%) subjects. At followup, upper urinary tract (UUT) abnormalities were seen in 11 (12.4%) subjects. Patients > 49 years old were more likely to have an abnormality (OR 0.181, 95% CI 0.037-0.892, p = 0.04). Patients with abnormal compliance were also more likely to have an abnormal followup RUS (OR 0.185, 95% CI 0.037-0.924, p = 0.04). No other demographic or UD factor was associated with RUS abnormalities.
  
  
  CONCLUSIONS
  The development of structural UUT changes is low in MS patients. Urodynamic studies are useful for LUTS treatment strategies in complicated patients, but UD does not appear to have much impact with regard to upper tract changes.
authors: Department of Urology, The Methodist Hospital, Houston, TX 77030, USA. sgfletcher@tmhs.org
authors: Sophie G
authors: SG
authors: Fletcher
authors: Benjamin E
authors: BE
authors: Dillon
authors: Alienor S
authors: AS
authors: Gilchrist
authors: Rashel M
authors: RM
authors: Haverkorn
authors: Jingsheng
authors: J
authors: Yan
authors: Elliot M
authors: EM
authors: Frohman
authors: Gary E
authors: GE
authors: Lemack
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D012189:Retrospective Studies; D001750:Urinary Bladder, Neurogenic / Q000209:etiology*; D014563:Urodynamics; D055815:Young Adult
keywords: Neurogenic bladder; lower urinary tract; multiple sclerosis; upper urinary tract; urodynamics; urological symptoms