title: Chronic kidney disease in neurogenic bladder.
abstract: OBJECTIVE
  It was believed that neurogenic bladder (NB) might be a risk factor of chronic kidney disease (CKD). However, data are limited regarding the real incidence or risk of CKD in NB. In addition, serum creatinine (sCr), a classical marker of renal function, is not reliable in NB patients because they present muscle wasting due to disuse or denervation. The aim of the study was to estimate the prevalence of CKD in NB patients using serum Cystatin-C. Secondly, we aimed to identify the risk factors for CKD development in NB.
  
  
  METHODS
  This was a cross-sectional study in a public hospital, a specialized center for patients who were victims of industrial accidents. Serum Cystatin-C was checked at the regular laboratory test in the structured NB programme of the hospital, and 313 patients were included in the study.
  
  
  RESULTS
  The overall prevalence of CKD, defined as estimated glomerular filtration rate (eGFR) <60/mL per 1.73m2was 8.0% and 22.4%, by sCr-based and Cystain-C-based eGFR, respectively, and was greater than age-matched general population in Korea. sCr was not able to detect the early deterioration of renal function in NB patients. Co-morbid diabetes, small bladder volume, recurrent urinary tract infection, and proteinuria were significantly associated with CKD in the multivariable analysis.
  
  
  CONCLUSIONS
  Chronic kidney disease prevalence was more than three times higher in NB patients than in the general population despite recent progress in the medical care of NB. Co-morbid diabetes, small bladder volume, recurrent urinary tract infection, and proteinuria seem to be the risk factors for CKD development in NB.
authors.affiliation: Department of Urology, Korea Workers' Compensation & Welfare Hospital, Incheon, South Korea.
authors.forename: Bong Mo
authors.initials: BM
authors.lastname: Sung
authors.affiliation: Department of Internal Medicine, Seonam University Myongji Hospital, Goyang, Gyeonggi-do, South Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Oh
authors.affiliation: Department of Laboratory Medicine, Korea Workers' Compensation & Welfare Hospital, Incheon, South Korea.
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Seonam University Myongji Hospital, Goyang, Gyeonggi-do, South Korea.
authors.forename: Hye Min
authors.initials: HM
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D055316:Cystatin C / Q000097:blood; D042241:Early Diagnosis; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D001750:Urinary Bladder, Neurogenic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D003404:Creatinine
keywords: Cystatin-C; chronic kidney disease; neurogenic bladder; risk factor; spinal cord injury