Cho A Jin, Kim Soo Jin, Lee Young-Ki, Song Young Rim, Oh Jieun, Kim Sung Gyun, Seo Jang Won, Yoon Jong-Woo, Koo Ja-Ryong, Kim Hyung Jik, Noh Jung Woo
Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Hallym Kidney Research Institute, Hallym University College of Medicine, Seoul, Republic of Korea.
Diabetes Res Clin Pract. 2015 Jul;109(1):164-9. doi: 10.1016/j.diabres.2015.04.014. Epub 2015 Apr 20.
Diabetic bladder dysfunction (DBD) is a common complication of type 2 diabetes mellitus (T2DM). The association between DBD and progression of diabetic nephropathy has not been clarified. In this study, we investigated the relationship between post-voiding residual urine (PVR) with decline in renal function in patients with type 2 diabetes. This retrospective study included 164 patients at a single center. We collected medical histories and laboratory findings of patients undergoing uroflowmetry from January 1, 2008 to October 30, 2013. Renal function was assessed by calculating the estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) study equation. We evaluated whether greater PVR was a risk factor for faster decline of GFR during a 1-year follow-up. The subjects' mean age was 65±12 years, duration of diabetes 12.8±8.8 years, baseline serum creatinine level 106.1±53.0 μmol/L, and eGFR was 64.6±25.2 mL/min/1.73 m(2). Mean PVR was 69.8±96.3 mL and in 17.7% of subjects, PVR>100 mL. In linear regression analysis, PVR was independently associated with GFR decrease (standardized β coefficient=0.2, P=0.009). Multiple logistic analysis showed that subjects with PVR>100 mL had a 2.8-fold higher risk of an eGFR change during 1 year higher than the median value of all subjects (95% confidence interval, 1.1-6.8; P=0.03). Increased PVR was independently associated with a more rapid decline in renal function in patients with type 2 diabetes.
糖尿病膀胱功能障碍（DBD）是2型糖尿病（T2DM）的常见并发症。DBD与糖尿病肾病进展之间的关联尚未明确。在本研究中，我们调查了2型糖尿病患者排尿后残余尿量（PVR）与肾功能下降之间的关系。这项回顾性研究纳入了单中心的164例患者。我们收集了2008年1月1日至2013年10月30日接受尿流率测定患者的病史和实验室检查结果。使用肾脏病饮食改良（MDRD）研究方程计算估计肾小球滤过率（eGFR）来评估肾功能。我们评估了在1年随访期间更高的PVR是否是GFR更快下降的危险因素。受试者的平均年龄为65±12岁，糖尿病病程为12.8±8.8年，基线血清肌酐水平为106.1±53.0μmol/L，eGFR为64.6±25.2 mL/min/1.73 m²。平均PVR为69.8±96.3 mL，17.7%的受试者PVR>100 mL。在线性回归分析中，PVR与GFR降低独立相关（标准化β系数=0.2，P=0.009）。多因素logistic分析显示，PVR>100 mL的受试者在1年内eGFR变化高于所有受试者中位数的风险高2.8倍（95%置信区间，1.1 - 6.8；P=0.03）。PVR增加与2型糖尿病患者肾功能更快下降独立相关。
