Abstract
The characteristics of end-stage renal disease associated with spinal cord injury were studied in 8 hemodialysis patients. The mean interval between the onset of spinal cord injury (SCI) and the institution of maintenance hemodialysis was 16.4 years. At the time of initiation of hemodialysis, the mean serum creatinine concentration was 7.2±2.5mg/dl and was markedly lower than that of the glomerulonephritic group. Mean bicarbonate was 10.9mEq/l, and mean Na was 122.1mEq/l. The main causes of the initiation of hemodialysis were fluid and electrolyte abnormalities, gastro-intestinal symptoms and heart failure. In many cases, emergency hemodialysis therapy was required. Two cases suffered from pneumonia. Surgical treatment for decubiti was undertaken in five cases, three of whom suffered from septicemia. Thus, more effective prevention and control of infections, nutrition and electrolyte balance would result in reduced morbidity and mortality rates in SCI patients. Vesicoureteral reflux (VUR) was found only in 3 kidneys of 2 cases, but hydronephrosis was present in 11 kidneys of 6 cases. Urinary tract infections associated with neurogenic bladder were the major cause of chronic renal failure in SCI patients. All SCI patients exhibited moderate to marked proteinuria, and glomerular abnormalities existed under these conditions. In conclusion, chronic renal failure complicating the course of long standing spinal cord injury represents a unique clinical condition.
