Mitsui Takahiko, Shimoda Naohiko, Morita Ken, Tanaka Hiroshi, Moriya Kimihiko, Nonomura Katsuya
Department of Urology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
Int J Urol. 2009 Apr;16(4):388-92. doi: 10.1111/j.1442-2042.2009.02252.x. Epub 2009 Feb 4.
To investigate lower urinary tract symptoms (LUTS) and their impact on quality of life (QOL) in patients having undergone renal transplantation (RTX).
Forty-three patients (25 males and 18 females; age 20-68 years) undergoing RTX at Hokkaido University Hospital were included in this study. Median follow-up after RTX was 41 months (range 6-184). Pre-transplant dialysis had been carried out in 38 patients (median: 4.3 years, range: 1 month-31 years). All patients were assessed by uroflowmetry (UFM), postvoid residual urine volume (PVR), 24 h bladder diary, and International Prostate Symptom Score (IPSS). QOL score and King's Health Questionnaire (KHQ) were used for the assessment of LUTS-related QOL.
Mean fluid intake volume and urine output volume for 24 h were 2136 mL (1150-3430 mL) and 2446 mL (1336-4733 mL), respectively. Voiding dysfunction assessed by UFM and PVR was observed in 12 patients (28%) showing higher IPSS. QOL score and overall QOL in KHQ were not different between patients with and without voiding dysfunction. Although 19 (49%) had polyuria, 20 (51%) had nocturnal polyuria, which affected nocturia in IPSS as well as sleep/energy disturbances in KHQ compared with patients without nocturnal polyuria.
Patients having RTX frequently present voiding dysfunction and nocturia basically caused by nocturnal polyuria. We should focus on LUTS in these patients to provide an appropriate management.
调查肾移植（RTX）患者的下尿路症状（LUTS）及其对生活质量（QOL）的影响。
本研究纳入了北海道大学医院接受RTX的43例患者（25例男性和18例女性；年龄20 - 68岁）。RTX后的中位随访时间为41个月（范围6 - 184个月）。38例患者进行了移植前透析（中位时间：4.3年，范围：1个月 - 31年）。所有患者均接受尿流率测定（UFM）、排尿后残余尿量（PVR）、24小时膀胱日记和国际前列腺症状评分（IPSS）评估。生活质量评分和国王健康问卷（KHQ）用于评估与LUTS相关的生活质量。
24小时平均液体摄入量和尿量分别为2136 mL（1150 - 3430 mL）和2446 mL（1336 - 4733 mL）。通过UFM和PVR评估的排尿功能障碍在12例患者（28%）中观察到，这些患者的IPSS较高。有和没有排尿功能障碍的患者之间，KHQ中的生活质量评分和总体生活质量没有差异。虽然19例（49%）有多尿症，20例（51%）有夜间多尿症，与没有夜间多尿症的患者相比，这影响了IPSS中的夜尿症以及KHQ中的睡眠/精力障碍。
接受RTX的患者经常出现排尿功能障碍和夜尿症，主要由夜间多尿引起。我们应关注这些患者的LUTS以提供适当的管理。
