Urinary high-sensitivity C-reactive protein in patients with neurogenic bladder after meningomyelocele (MMC)

Abstract

Introduction. Neurogenic bladder (NB) is specific condition caused by disturbed bladder innervation and the most often complication of meningomyelocele (MMC). It is known that incorrect bladder function causes renal damage. Condition of  NB is worsened by urinary tract infections, detrusor overactivity, dysfunctional voiding and/or irregular catheterization. hs-CRP plays an important role in inflammatory process and can predict kidney function.  The aim of this study was the estimation of urinary hs-CRP level in association with neurogenic bladder function based on urodynamics and renal function based on eGFR in MMC patients with various activity states and with different levels of lesion. Material and methods. 33 children and adolescents with urodynamically  confirmed neurogenic bladder and 20 healthy individuals were enrolled into the study. Patients were divided according to Hoffer’s scale and level of lesion. Urinary hs-CRP were evaluated in all individuals using ELISA methods. Urinary hs-CRP results were adjusted to the creatinine and expressed as hs-CRP/creatinine ratio. Nonparametric tests were used for statistical analysis. Results. When compared to the reference group, MMC patients showed increased urinary hs-CRP. There were no differences in the studied parameter between boys and girls, non- and catheterized, and with different urodynamic diagnosed children. We found positive correlations between Hoffer’s scale assessing physical activity and level of lesion and between GFR and urinary hs-CRP/crea. Conclusion. Urinary hs-CRP level is elevated in MMC patients compared to reference group and could be considered as a very early marker of glomerular hyperfiltration.