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肾移植成功后下尿路功能障碍及症状的危险因素

Risk Factors for Lower Urinary Tract Dysfunction and Symptoms After Successful Renal Transplantation.

作者信息

Mitsui Takahiko, Moriya Kimihiko, Morita Ken, Iwami Daiki, Kitta Takeya, Kanno Yukiko, Takeda Masayuki, Shinohara Nobuo

机构信息

Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo-city, Japan.

出版信息

Ann Transplant. 2015 Dec 24;20:757-63. doi: 10.12659/aot.895515.

Abstract

BACKGROUND

We investigated risk factors for lower urinary tract (LUT) dysfunction and LUT symptoms in patients who successfully underwent renal transplantation (RTX).

MATERIAL AND METHODS

Ninety-five patients (54 males and 41 females) undergoing RTX (median age: 45 years old) at Hokkaido University Hospital were included in this study. Uroflowmetry (UFM), postvoid residual urine volume (PVR), and 24-h bladder diaries were performed. We analyzed risk factors for voiding dysfunction, urinary frequency, polyuria, nocturia, and nocturnal polyuria after RTX using logistic regression analysis.

RESULTS

End-stage renal disease arose from diabetes mellitus in 18 patients (19%). Pre-transplant dialysis had been carried out in 74 patients. Voiding dysfunction as assessed by UFM and PVR was observed in 24 patients (27%). Based on the 24-h bladder diaries, we identified frequent micturition in 29 patients (35%), polyuria in 44 (54%), nocturia in 30 (37%), and nocturnal polyuria in 46 (56%). A multivariable logistic regression analysis revealed that diabetes mellitus, which may cause autonomic disorders, was a risk factor for voiding dysfunction and nocturnal polyuria. A risk factor for frequent micturition and nocturia was older age at RTX. Being female was a risk factor for polyuria, which suggested that fluid intake in relation to body weight was higher in females.

CONCLUSIONS

LUT dysfunction and LUT symptoms were not uncommon in patients who successfully underwent RTX. LUT dysfunction and LUT symptoms need to be considered in patients with risk factors such as diabetes mellitus, older age at RTX, and being female, even after successful RTX.

摘要

背景

我们调查了成功接受肾移植(RTX)患者下尿路(LUT)功能障碍和LUT症状的危险因素。

材料与方法

本研究纳入了北海道大学医院95例接受RTX的患者(54例男性和41例女性),中位年龄为45岁。进行了尿流率测定(UFM)、排尿后残余尿量(PVR)和24小时膀胱日记。我们使用逻辑回归分析RTX后排尿功能障碍、尿频、多尿、夜尿症和夜间多尿的危险因素。

结果

18例患者(19%)的终末期肾病由糖尿病引起。74例患者进行了移植前透析。24例患者(27%)观察到UFM和PVR评估的排尿功能障碍。根据24小时膀胱日记,我们确定29例患者(35%)尿频,44例(54%)多尿,30例(37%)夜尿症,46例(56%)夜间多尿。多变量逻辑回归分析显示,可能导致自主神经紊乱的糖尿病是排尿功能障碍和夜间多尿的危险因素。尿频和夜尿症的危险因素是RTX时年龄较大。女性是多尿的危险因素,这表明女性相对于体重的液体摄入量较高。

结论

成功接受RTX的患者中LUT功能障碍和LUT症状并不少见。即使在RTX成功后,对于有糖尿病、RTX时年龄较大和女性等危险因素的患者,也需要考虑LUT功能障碍和LUT症状。

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