TIL: Vincent's curtsey is the actual medical term for the clinical sign of urinary incompetence, especially in kids on the playground. I'd include a picture but I think you know what this looks like - crossed legs, partially bent, probably bouncing up and down. This is normal if you've been in a confined space for eight hours and really need to go, but if a kid is at recess and always seems to stand like this, they likely have a medical condition and should see a urologist.
Spinal cord trauma can cause kidney failure in a round about way. The injury paralyzes the urinary sphincter muscles, which are the only muscles around the bladder over which we have direct conscious control. The muscles that compress the bladder work independently and use secondary signals to determine when to contract. Things are wired this way because the sphincters that block the ureters (inlets to the bladder from the kidneys) are weaker than the sphincter to the urethra (outlet used for micturation (peeing)). If you could compress the bladder without opening the urethral sphincter, urine would go the wrong way.
With the spinal cord injury, this is exactly what happens, albeit without the person's control. The urethral sphincter is tonically closed due to the injury. Urine and pressure build up in the bladder until the sphincters that block the ureters are overcome and urine flows back to the kidneys, raising the pressure there. The kidneys cannot function under this pressure and will fail. The take home message is to always check that a patient with a spinal cord injury is either urinarily competent or with a catheter.
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