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

Silvia Lai; Serena Pastore; Leonardo Piloni; Marco Mangiulli; Ylenia Esposito; Federico Pierella; Alessandro Galani; Giovanni Pintus; Daniela Mastroluca; Hossein Shahabadi; Mauro Ciccariello; Stefano Salciccia; Magnus Von Heland; Study Group on Geriatric Nephrology of the Italian Society of Nephrology (SIN)

doi:10.1093/ckj/sfy085

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

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

Authors

Affiliations

¹ Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy.
² Department of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy.
³ Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome, Italy.
⁴ Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
⁵ Nephrology and Dialysis Unit, Hospital ICOT Latina, Sapienza University of Rome, Rome, Italy.
⁶ Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy.

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 (Q _max), 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 Q _max (P < 0.001) while 21 females reported a significant increase of Q _max (P < 0.001) with a prevalence of 49.5% of functional urological disease. Moreover, we showed a significant association between Q _max 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 Q _max altered with CKD (χ² = 1.885, P = 0.170) and recurrent infection (χ² = 8.886, P = 0.012), while we have not shown an association with proteinuria (χ² = 0.484, P = 0.785), diabetes (χ² = 0.334, P = 0.563) or hypertension (χ² = 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.

Keywords: chronic kidney disease; end-stage renal disease; max flow rate; uroflowmetry; urological disorders.