常染色体显性遗传性多囊肾病患者的尿流率测定改变。

Uroflowmetry alterations in patients with autosomal dominant polycystic kidney disease.

机构信息

Department of Translational and Precision Medicine, UOC Nephrology, Sapienza University of Rome, Rome, Italy.

出版信息

Eur Rev Med Pharmacol Sci. 2019 Apr;23(7):2734-2743. doi: 10.26355/eurrev_201904_17546.

DOI:10.26355/eurrev_201904_17546

PMID:31002123

Abstract

OBJECTIVE

Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a heterogeneous inherited disease characterized by renal and extrarenal manifestations with progressive fluid-filled cyst development leading to end-stage renal disease. Our aim was to evaluate the prevalence of obstructive urological disease in ADPKD patients and possible associations with endothelial dysfunction, nutritional, metabolic and inflammatory markers.

PATIENTS AND METHODS

The study included ADPKD patients and control group, who carried out uroflowmetry, an assessment of renal function, metabolic and nutritional parameters and an evaluation of endothelial dysfunction and atherosclerotic markers, such as Renal Resistive Index (RRI), Intima-Media Thickness (IMT) and Flow-Mediated Dilation (FMD).

RESULTS

We enrolled 37 ADPKD patients (20 males with 51.0 ± 14.3 years) and 34 control group (18 males with 60.7 ± 14.4 years). We showed a significant reduction in Max Flow Rate (Qmax) (p ≤ 0.001), age (p = 0.006), FMD (p = 0.023) and Voiding Volume (p = 0.053), in addition to a significant increase in Voiding Time and Diastolic Blood Pressure (p ≤ 0.001, p = 0.049; respectively) in ADPKD patients with respect to control group. Moreover, we found a negative correlation between Qmax and creatinine (r= -0.44, p = 0.007), RRI (r= -0.49, p ≤0.001) and intact Parathyroid Hormone (r = -0.329, p = 0.046), while we found a positive correlation between Qmax and MDRD (r = 0.327, p = 0.048) and between Voiding Time and serum uric acid (r= 0.34, p = 0.039) in ADPKD patients with respect to control group.

CONCLUSIONS

In our study, we showed an elevated prevalence of urological functional diseases in ADPKD patients; therefore, we suggest to include uroflowmetry in the assessment of these patients, considering the non-invasiveness, repeatability and low cost of the exam. An early intervention could slow down the progression of renal damage and an early screening of the main cardiovascular risk factors could reduce the high morbidity and mortality in ADPKD patients.

摘要

目的

常染色体显性多囊肾病（ADPKD）是一种异质性遗传疾病，其特征为肾脏和肾外表现，伴有进行性充满液体的囊肿发育，导致终末期肾病。我们的目的是评估 ADPKD 患者中梗阻性尿路疾病的患病率，并探讨其与内皮功能障碍、营养、代谢和炎症标志物的可能相关性。

方法

该研究纳入了 ADPKD 患者和对照组，进行了尿流率测定、肾功能评估、代谢和营养参数评估以及内皮功能障碍和动脉粥样硬化标志物（如肾阻力指数[RRI]、内-中膜厚度[IMT]和血流介导的扩张[FMD]）评估。

结果

我们共纳入了 37 名 ADPKD 患者（20 名男性，年龄 51.0 ± 14.3 岁）和 34 名对照组（18 名男性，年龄 60.7 ± 14.4 岁）。我们发现 ADPKD 患者的最大尿流率（Qmax）显著降低（p ≤ 0.001），年龄（p = 0.006）、FMD（p = 0.023）和排尿量（p = 0.053）也显著降低，而排尿时间和舒张压则显著升高（p ≤ 0.001，p = 0.049；分别）。此外，我们发现 Qmax 与肌酐（r= -0.44，p = 0.007）、RRI（r= -0.49，p ≤0.001）和完整甲状旁腺激素（r = -0.329，p = 0.046）呈负相关，而与 MDRD（r = 0.327，p = 0.048）和尿酸（r= 0.34，p = 0.039）呈正相关。