Renal deterioration in multiple sclerosis patients with neurovesical dysfunction

This research group looked at the prevalence of renal ultrasound (RUS) abnormalities over time in people with MS with lower urinary tract symptoms (LUTS). They found that on initial urological examination, which included urodynamics (UD) and renal ultrasound (RUS), 5.8% of MS patients with LUTS had renal abnormalities, nearly all of them subtle.

With a median follow-up of 61 months, they found 12.4% of patients had an abnormality detected on RUS, however, none had an abnormal serum creatinine. Advanced age and abnormal compliance were relative risks for upper urinary tract (UUT) abnormalities. Therefore patients with clinically stable MS are at a low risk for UUT pathology.

Their suggested approach to the neurologically stable MS patient involves a minimally-invasive office evaluation of symptom assessment and post void residual. Patients with large or increasing residuals despite treatment can be evaluated with urodynamics. Upper tract imaging should be considered if previous renal abnormalities, previous pathology, symptoms of renal pathology or advanced neurological deterioration are present.

Authors: Fletcher SG, Dillon BE, Gilchrist AS

Source: Mult Scler. 2013 Jan 21. [Epub ahead of print]

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