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慢性肾病与泌尿系统疾病:肾病患者尿流率测定的系统应用

Chronic kidney disease and urological disorders: systematic use of uroflowmetry in nephropathic patients.

作者信息

Lai Silvia, Pastore Serena, Piloni Leonardo, Mangiulli Marco, Esposito Ylenia, Pierella Federico, Galani Alessandro, Pintus Giovanni, Mastroluca Daniela, Shahabadi Hossein, Ciccariello Mauro, Salciccia Stefano, Von Heland Magnus

机构信息

Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.

Department of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy.

出版信息

Clin Kidney J. 2018 Sep 27;12(3):414-419. doi: 10.1093/ckj/sfy085. eCollection 2019 Jun.

Abstract

BACKGROUND

Chronic kidney disease (CKD) is a highly prevalent condition. Urologic disorders are known causes of CKD, but often remain undiagnosed and underestimated also for their insidious onset and slow progression. We aimed to evaluate the prevalence of urological unrecognized diseases in CKD patients by uroflowmetry.

METHODS

We enrolled consecutive stable CKD outpatients. The patients carried out two questionnaires, the International Prostate Symptom Score and Incontinence Questionnaire-Short Form, and they also underwent uroflowmetry, evaluating max flow rate ( ), voiding time and voided volume values.

RESULTS

A total of 83 patients (43 males, mean age of 59.8 ± 13.3 years) were enrolled. Our study showed 28 males and 10 females with a significant reduction of (P < 0.001) while 21 females reported a significant increase of (P < 0.001) with a prevalence of 49.5% of functional urological disease. Moreover, we showed a significant association between and creatinine (P = 0.013), estimated glomerular filtration rate (P = 0.029) and voiding volume (P = 0.05). We have not shown significant associations with age (P = 0.215), body mass index (P = 0.793), systolic blood pressure (P = 0.642) or diastolic blood pressure (P = 0.305). Moreover, Pearson's chi-squared test showed a significant association between altered with CKD (χ  = 1.885, P = 0.170) and recurrent infection (χ = 8.886, P = 0.012), while we have not shown an association with proteinuria (χ = 0.484, P = 0.785), diabetes (χ = 0.334, P = 0.563) or hypertension (χ = 1.885, P = 0.170).

CONCLUSIONS

We showed an elevated prevalence of urological diseases in nephropathic patients; therefore, we suggest to include uroflowmetry in CKD patient assessment, considering the non-invasiveness, repeatability and low cost of examination. Uroflowmetry could be used to identify previously unrecognized urological diseases, which may prevent the onset of CKD or progression to end-stage renal disease and reduce the costs of management.

摘要

背景

慢性肾脏病(CKD)是一种高度流行的疾病。泌尿系统疾病是CKD的已知病因,但由于其隐匿性起病和进展缓慢,往往仍未被诊断和低估。我们旨在通过尿流率测定评估CKD患者中未被识别的泌尿系统疾病的患病率。

方法

我们纳入了连续的稳定CKD门诊患者。患者填写了两份问卷,即国际前列腺症状评分和尿失禁问卷简表,并且还接受了尿流率测定,评估最大尿流率( )、排尿时间和排尿量值。

结果

共纳入83例患者(43例男性,平均年龄59.8±13.3岁)。我们的研究显示,28例男性和10例女性的 显著降低(P<0.001),而21例女性报告 显著增加(P<0.001),功能性泌尿系统疾病的患病率为49.5%。此外,我们发现 与肌酐(P=0.013)、估计肾小球滤过率(P=0.029)和排尿量(P=0.05)之间存在显著关联。我们未发现与年龄(P=0.215)、体重指数(P=0.793)、收缩压(P=0.642)或舒张压(P=0.305)有显著关联。此外,Pearson卡方检验显示,CKD导致的 改变(χ =1.885,P=0.170)与反复感染(χ=8.886,P=0.012)之间存在显著关联,而我们未发现与蛋白尿(χ=0.484,P=0.785)、糖尿病(χ=0.334,P=0.563)或高血压(χ=1.885,P=0.170)有关联。

结论

我们发现肾病患者中泌尿系统疾病的患病率较高;因此,考虑到检查的非侵入性、可重复性和低成本,我们建议在CKD患者评估中纳入尿流率测定。尿流率测定可用于识别先前未被识别的泌尿系统疾病,这可能预防CKD的发生或进展至终末期肾病,并降低管理成本。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ce6/6543956/dbe04fdaf8ca/sfy085f1.jpg

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