Abstract
Study design
Scoping review - standardized according to the Equator-network and the Prisma-Statement guidelines with PRISMA-ScR.
Objectives
Review the literature concerning surveillance of the urinary- and renal systems in persons with spinal cord injuries (SCI). Specifically, to assess: #1 the usability of non-invasive and non-ultrasound methods, #2 the usage of systematic ultrasound surveillance #3 patient characteristics which predispose to urinary tract abnormalities (UTA) or renal function deterioration.
Methods
The literature assessed was collected from PubMed by creating a search string comprised of three main phrases: #1 persons with SCI, #2 kidney function and #3 surveillance program. The final search resulted in 685 studies. Eligibility criteria were defined prior to the search to assess the studies systematically.
Results
Four studies found serum cystatin C (s-cysC) to be accurate in estimating the glomerular filtration rate in persons with SCI. One study found no difference in UTA between surveillance adherent and surveillance non-adherent persons up to 30 years post injury. UTA and especially renal function deterioration seems rare the first 15 years post-injury. Non-traumatic SCI, time since injury, high detrusor pressure, upper urinary tract dilation, vesicourethral reflux, trabeculated bladder, history of calculi removal are significant risk factors for developing UTA or renal function deterioration.
Conclusion
Measurements of S-cysC should be considered to replace serum creatinine in most cases. Surveillance non-adherent persons are not at higher risk of developing UTA. A selective surveillance based on a baseline risk profile may be beneficial for patients and caretakers.
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CB was responsible for designing the protocol in cooperation with KES, conducting full text readings of selected papers, extracting, and analysing data as well as writing the final report. MFR was responsible for creating the initial search string and excluding papers by assessment of the titles and abstracts. BYAK provided important feedback in the last stages before submitting. RMH provided feedback in all steps, from assessing studies to completing the final report. KES was responsible for designing the protocol and providing feedback in all steps, from assessing studies to completing the final report.
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Bødker, C., Riisbøl, M.F., Khan, B.Y.A. et al. Urologic surveillance of persons with spinal cord injuries – a scoping review. Spinal Cord 62, 91–98 (2024). https://doi.org/10.1038/s41393-023-00955-6
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DOI: https://doi.org/10.1038/s41393-023-00955-6