Objective: To determine the effect of different bladder management methods on long-term renal function in persons with spinal cord injury (SCI). Design: Cohort study. Setting: Model SCI care system within a large teaching hospital. Patients: Consecutive sample of 1,114 persons with SCI who were injured between 1969 and 1994. Main Outcome Measure: Total and individual kidney effective renal plasma flow (ERPF). Results: ERPF was generally lower in persons with cervical injuries or kidneys that had a renal stone, older persons, and women. Overall, there was very little change in renal function as time postinjury increased, and there were no clinically meaningful differences in the change in renal function over time among persons using different bladder management methods. Conclusion: Renal function was adequately preserved in the great majority of persons and did not appear to be influenced to any great extent by method of bladder management.