To investigate the role of albuminuria as a clinical marker of early renal disease in children with neurogenic bladder (NGB) in association with commonly used predictors of renal risk.
Catheterized urine was obtained from 40 patients with NGB at a tertiary pediatric hospital. Albumin-to-creatinine ratio (ACR) was analyzed for associations with estimated glomerular filtration rate, vesicoureteral reflux, hydronephrosis, bladder dynamics, and renal scarring.
About 32% (13/40) of NGB patients had elevated ACR (≥30 mg/g. Elevated ACR was associated with Caucasian race, clean intermittent catheterization, hydronephrosis, and vesicoureteral reflux on univariate analysis. In multivariable analysis, presence of vesicoureteral reflux and use of anticholinergic medication were significant predictors of ACR elevation.
Albuminuria is an established clinical predictor of renal disease and risk for progression to renal failure. The presence of albuminuria in NGB patients with urinary tract abnormalities suggests these patients may be at increased risk for progressive renal disease. This supports the clinical utility of adding ACR to the evaluation of renal risk in pediatric NGB.
Urology. 2019 Aug 24 [Epub]
Rachel O Millner, Janae Preece, Ann Salvator, Daryl J McLeod, Christina B Ching, Brian Becknell
Nephrology and Urology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Nephrology Division, Nationwide Children's Hospital, Columbus, OH., Nephrology and Urology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Division of Pediatric Urology, Children's Hospital of Michigan, Detroit, MI., Biostatistics Resources at NCH, Columbus, OH, USA., Nephrology and Urology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Division of Pediatric Urology, Department of Surgery, Nationwide Children's Hospital, Columbus, OH; Center for Surgical Outcomes Research and Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH., Nephrology and Urology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Division of Pediatric Urology, Department of Surgery, Nationwide Children's Hospital, Columbus, OH; Center for Clinical and Translational Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH., Nephrology and Urology Research Affinity Group, The Research Institute at Nationwide Children's Hospital, Columbus, OH; Nephrology Division, Nationwide Children's Hospital, Columbus, OH; Center for Clinical and Translational Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH. Electronic address: .