Factors Associated With Renal and Urological Complications in Patients Suffering From Spinal Cord Injuries During Subsequent Years of Post-Injury

Renal and urological complications are the main causes of mortality and morbidity associated with spinal cord injury (SCI). Besides clinical risk factors, there are environmental predisposing factors making a patient prone to develop any complications. The present study aimed to evaluate the risk factors of developing nephrolithiasis, urinary tract infection, hydronephrosis and renal failure, as the main renal and urological complications in the SCI patients. The database of SCI patients of State Welfare Organization of Iran (SWOI) was used for data gathering. The data were collected between 2008 and 2010 by 222 separate teams consisting of 6 mobile rehabilitation team members. The independent risk factors of developing nephrolithiasis, urinary tract infection, hydronephrosis and renal failure were recognized by controlling the confounders after entering all biologically plausible variables in multivariate regression models. Complete information was available for 5901 (72.59%) of the patients. Urologic and renal complications were reported in 2358 (40%) of the patients among which 286 (4.8%) had chronic renal failure, 127 (2.2%) from hydronephrosis, 307 (5.2%) from nephrolithiasis and 2138 (36.2%) from urinary tract infection. Generally, renal and urological complications associated with old age, and more time since SCI; however, lumbar level of injury and living in rural area negatively correlated with renal and urological complications. SCI patients with and without renal and urological complications are different regarding demographic and environmental factors; hence, it is necessary to determine the modifiable risk factors in patients'' life-style to design preventive programs.