The association between an abnormal post-voiding urine volume and a lower estimated glomerular filtration rate in patients with type 2 diabetes with no voiding symptoms
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Diabetic cystopathy is a frequent complication of diabetesmellitus. This study assessed the association between the post-voiding residual(PVR) urine volume and diabetic nephropathy in type 2 diabetics with no voidingsymptoms. Methods: This study investigated 42 patients with type 2 diabetes who were followedregularly at our outpatient clinic between July 1, 2008 and June 30, 2009. No patient had voiding problems or International Prostate Symptom Scores (IPSSs)≥ 12. An urologist performed the urological evaluations and the PVR was measuredusing a bladder scan. A PVR > 50 mL on two consecutive voids was consideredabnormal, which was the primary study outcome. Results: The mean patient age was 60 ± 10 years; the IPSS score was 3.7 ± 3.3; andthe diabetes duration was 11.9 ± 7.8 years. Seven of the 42 patients (16.7%) had aPVR > 50 mL. The presence of overt proteinuria or microalbuminuria was associatedwith an increased risk of a PVR > 50 mL (p < 0.01). Patients with a PVR >50 mL had a significantly lower estimated glomerular filtration rate (eGFR) comparedwith those with a PVR ≤ 50 mL (59.2 ± 27.1 mL/min/1.73 m2 vs. 28.7 ± 23.3 mL/min/1.73 m2; p < 0.001). Multivariate logistic analysis revealed that a lower eGFR(odds ratio, 0.94; 95% confidence interval, 0.88 to 0.99; p = 0.04) was a significantrisk factor for a PVR > 50 mL. Conclusions: Patients with diabetic nephropathy had a significantly higher PVRand a lower eGFR was associated with an abnormal PVR.
Abstract
Background/Aims: Diabetic cystopathy is a frequent complication of diabetesmellitus. This study assessed the association between the post-voiding residual(PVR) urine volume and diabetic nephropathy in type 2 diabetics with no voidingsymptoms. Methods: This study investigated 42 patients with type 2 diabetes who were followedregularly at our outpatient clinic between July 1, 2008 and June 30, 2009. No patient had voiding problems or International Prostate Symptom Scores (IPSSs)≥ 12. An urologist performed the urological evaluations and the PVR was measuredusing a bladder scan. A PVR > 50 mL on two consecutive voids was consideredabnormal, which was the primary study outcome. Results: The mean patient age was 60 ± 10 years; the IPSS score was 3.7 ± 3.3; andthe diabetes duration was 11.9 ± 7.8 years. Seven of the 42 patients (16.7%) had aPVR > 50 mL. The presence of overt proteinuria or microalbuminuria was associatedwith an increased risk of a PVR > 50 mL (p < 0.01). Patients with a PVR >50 mL had a significantly lower estimated glomerular filtration rate (eGFR) comparedwith those with a PVR ≤ 50 mL (59.2 ± 27.1 mL/min/1.73 m2 vs. 28.7 ± 23.3 mL/min/1.73 m2; p < 0.001). Multivariate logistic analysis revealed that a lower eGFR(odds ratio, 0.94; 95% confidence interval, 0.88 to 0.99; p = 0.04) was a significantrisk factor for a PVR > 50 mL. Conclusions: Patients with diabetic nephropathy had a significantly higher PVRand a lower eGFR was associated with an abnormal PVR.
참고문헌 (20)
- Frimodt-Moller C., "Diabetic cystopathy: a review of the urodynamic and clinical features of neurogenic bladder dysfunction in diabetes mellitus", Dan Med Bull, 25, pp.49~60 (1978)
- Frimodt-Moller C., "Diabetic cystopathy: epidemiology and related disorders", Ann Intern Med, 92(2 Pt 2), pp.318~321 (1980)
- Buck AC, "Bladder dysfunction and neuropathy in diabetes", Diabetologia, 12, pp.251~258 (1976)
- Sasaki K, "Implications of diabetes mellitus in urology", Urol Clin North Am, 30, pp.1~12 (2003)
- Faerman I, "Asymptomatic neurogenic bladder in juvenile diabetics", Diabetologia, 7, pp.168~172 (1971)
- Ellenberg M., "Development of urinary bladder dysfunction in diabetes mellitus", Ann Intern Med, 92(2 Pt 2), pp.321~323 (1980)
- Kaplan SA, "Urodynamic findings in patients with diabetic cystopathy", J Urol, 153, pp.342~344 (1995)
- Ueda T, "Diabetic cystopathy:relationship to autonomic neuropathy detected by sympathetic skin response", J Urol, 157, pp.580~584 (1997)
- Yoshimura N, "Recent advances in understanding the biology of diabetes-associated bladder complications and novel therapy", BJU Int, 95, pp.733~738 (2005)
- Norden G, "Diabetic cystopathy: a risk factor in diabetic nephropathy?", J Diabet Complications, 2, pp.203~206 (1988)
- Andersen JT, "Early detection of diabetic visceral neuropathy: an electrophysiologic study of bladder and urethral innervation", Diabetes, 25, pp.1100~1105 (1976)
- Bright E, "Automatic evaluation of ultrasonography-estimated bladder weight and bladder wall thickness in community-dwelling men with presumably normal bladder function", BJU Int, 109, pp.1044~1049 (2012)
- Barry MJ, "The American Urological Association symptom index for benign prostatic hyperplasia: the Measurement Committee of the American Urological Association", J Urol, 148, pp.1549~1557 (1992)
- Levey AS, "Expressing the Modification of Diet in Renal Disease Study equation for estimating glomerular filtration rate with standardized serum creatinine values", Clin Chem, 53, pp.766~772 (2007)
- National Kidney Foundation, "KDOQI Clinical Practice Guideline for diabetes and CKD: 2012 update", Am J Kidney Dis, 60, pp.850~886 (2012)
- Kelly CE., "Evaluation of voiding dysfunction and measurement of bladder volume", Rev Urol, 6(Suppl 1), pp.S32~S37 (2004)
- Torffvit O, "Lack of association between cystopathy and progression of diabetic nephropathy in insulin-dependent diabetes mellitus", Scand J Urol Nephrol, 31, pp.365~369 (1997)
- Esteghamati A, "The association between urodynamic findings and microvascular complications in patients with long-term type 2 diabetes but without voiding symptoms", Diabetes Res Clin Pract, 78, pp.42~50 (2007)
- Kebapci N, "Bladder dysfunction in type 2 diabetic patients", Neurourol Urodyn, 26, pp.814~819 (2007)
- Moller CF., "Diabetic cystopathy.II: relationship to some late-diabetic manifestations", Dan Med Bull, 23, pp.279~287 (1976)