Abstract

Chronic kidney disease (CKD) and spinal cord injury and disorders (SCI/D) are common and costly conditions among Veterans. However, little is known about CKD among adults with SCI/D. We conducted cross-sectional analyses of Veterans with SCI/D across all VA facilities in 2006. CKD was defined as an estimated glomerular filtration rate (eGFR) <60 ml min 1.73 m(2) and categorized by standard egfr strata. egfr was calculated in two ways: (a) the modification of diet in renal disease (mdrd) equation and (b) the mdrd equation + an empirically derived correction factor for sci d (mdrd-sci d). logistic regression models were used to examine the relationship between patient characteristics and ckd. among 9,333 sci d veterans with an available egfr, the proportion with ckd was substantially higher based on the mdrd-sci d equation (35.2%) than based on the mdrd equation (10.2%). in adjusted analyses, while older age (or for>65 years = 2.53; 95% CI: 2.21-2.89), female sex (OR 2.18; 95% CI: 1.62-2.92), and a non-traumatic cause for injury (OR 1.39; 95% CI: 1.23-1.57) were associated with an increased odds of CKD, black race (OR 0.64; 95% CI: 0.56-0.72) and a duration of injury of ≥10 years (OR 0.76; 95% CI: 0.67-0.86) were associated with a decreased odds of CKD. Diagnostic codes for CKD and nephrology visits were infrequent for SCI/D Veterans with CKD (27.51 and 6.58%, respectively). Using a recently validated version of the MDRD equation with a correction factor for SCI/D, over 1 in 3 Veterans with SCI/D had CKD, which is more than 3-fold higher than when traditional MDRD estimation is used.

DOI 10.1159/000345460