Risk factors for development of proteinuria in chronic spinal cord injury

A retrospective, case-control study was performed to investigate the risk f actors that may contribute to the development of proteinuria in patients wi th chronic spinal cord injury (SCI), During an 18-month period, 31 subjects with a 24-hour protein excretion of 1.0 g or greater were identified, Thre e control subjects with SCIs with a 24-hour urinary protein excretion of le ss than 1.0 g during the same time period were randomly selected for each s tudy subject with proteinuria. Clinical data, including level and duration of injury, age, presence of indwelling bladder catheter, number of decubitu s ulcer procedures, serum albumin and creatinine concentrations, hematocrit , creatinine clearance, and the presence of hypertension and diabetes melli tus, were obtained from medical records, Subjects with proteinuria had othe r evidence of renal dysfunction with greater serum creatinine concentration s and reduced creatinine clearances, serum albumin concentrations, and hema tocrits, Proteinuric subjects were older, had a longer duration of injury, had undergone a greater number of decubitus ulcer procedures, and were more likely to have hypertension and indwelling bladder catheters. The independ ent predictors for the development of proteinuria using logistic stepwise m ultiple linear regression analysis were the use of chronic indwelling bladd er catheters, number of decubitis ulcer procedures, presence of hypertensio n, and older age, These data suggest that inflammatory complications associ ated with complications of chronic SCI, rather than SCI per se, contribute to the development of proteinuria. SCI patients with proteinuria have more impaired renal function and increased mortality compared with SCI patients without proteinuria. (C) 1999 by the National Kidney Foundation, Inc.