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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

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      Correlation Between Benign Prostatic Hyperplasia/Lower Urinary Tract Symptoms and Renal Function in Elderly Men Aged 80 Years and Older

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          Abstract

          Purpose

          To investigate the relationship between benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and renal function in elderly men aged 80 years and older.

          Patients and Methods

          We selected 389 elderly men aged 80–97 years with BPH/LUTS hospitalized at The Second Division of General Geriatrics, The First Affiliated Hospital of Zhengzhou University, between July 2018 and July 2020. In the cross-sectional study, patients were divided into the treatment (233 patients) and non-treatment (156 patients) groups based on whether they received treatment for BPH/LUTS. In the prospective self-case-control study, we included 129 of the non-treatment group patients who received oral BPH/LUTS medication and completed the 6-month outpatient follow-up. We compared prostate indicators and renal function in the cross-sectional study and baseline and after-treatment data in the prospective self-case-control study. Multiple linear regression analysis was performed for risk factors affecting renal function before and after BPH/LUTS treatment.

          Results

          In the cross-sectional study, renal function was significantly better in the treatment group than in the non-treatment group. In the subgroup analysis of the prospective self-case-control study, renal function significantly improved after treatment among patients with hypertension and those with chronic kidney disease (CKD) 3a, but not in the entire cohort. Multivariable linear regression analysis showed that hypertension (β=2.06, 95% CI 0.40 to 3.71) and CKD 3a (β=17.16, 95% CI 15.53 to 18.79) were independent risk factors for creatinine differences before and after treatment, whereas hypertension (β=−2.27, 95% CI −3.65 to −0.89), CKD 3a (β=−11.93, 95% CI −13.29 to −10.58), and baseline prostate volume (β=−0.11, 95% CI −0.20 to −0.02) were independent risk factors for estimated glomerular filtration rate differences before and after treatment.

          Conclusion

          Treatment for moderate and severe BPH/LUTS can improve renal function in elderly patients with hypertension or CKD 3a.

          Most cited references25

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          Renal Aging: Causes and Consequences.

          Individuals age >65 years old are the fastest expanding population demographic throughout the developed world. Consequently, more aged patients than before are receiving diagnoses of impaired renal function and nephrosclerosis-age-associated histologic changes in the kidneys. Recent studies have shown that the aged kidney undergoes a range of structural changes and has altered transcriptomic, hemodynamic, and physiologic behavior at rest and in response to renal insults. These changes impair the ability of the kidney to withstand and recover from injury, contributing to the high susceptibility of the aged population to AKI and their increased propensity to develop subsequent progressive CKD. In this review, we examine these features of the aged kidney and explore the various validated and putative pathways contributing to the changes observed with aging in both experimental animal models and humans. We also discuss the potential for additional study to increase understanding of the aged kidney and lead to novel therapeutic strategies.
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            EAU Guidelines on the Assessment of Non-neurogenic Male Lower Urinary Tract Symptoms including Benign Prostatic Obstruction.

            Lower urinary tract symptoms (LUTS) represent one of the most common clinical complaints in adult men and have multifactorial aetiology.
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              Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA GUIDELINE PART I—Initial Work-up and Medical Management

              Benign prostatic hyperplasia (BPH) is a histologic diagnosis describing proliferation of smooth muscle and epithelial cells within the prostatic transition zone. The prevalence and severity of lower urinary tract symptoms (LUTS) in aging men are progressive and impact the health and welfare of society. This revised Guideline provides a useful reference on effective evidence-based management of male LUTS/BPH. See the accompanying algorithm for a summary of the procedures detailed in the Guideline (figures 1 and 2[Figure: see text][Figure: see text]).
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                Author and article information

                Journal
                Clin Interv Aging
                Clin Interv Aging
                cia
                Clinical Interventions in Aging
                Dove
                1176-9092
                1178-1998
                13 January 2023
                2023
                : 18
                : 61-69
                Affiliations
                [1 ]The Second Division of General Geriatrics, Department of Geriatrics, the First Affiliated Hospital of Zhengzhou University , Zhengzhou, Henan, People’s Republic of China
                [2 ]Division of Endocrinology, Department of Medicine, the First Affiliated Hospital of Zhengzhou University , Zhengzhou, Henan, People’s Republic of China
                [3 ]Department of Pharmacy, the First Affiliated Hospital of Zhengzhou University , Zhengzhou, Henan, People’s Republic of China
                [4 ]Division of Ultrasound, Department of Medical Imaging, the First Affiliated Hospital of Zhengzhou University , Zhengzhou, Henan, People’s Republic of China
                Author notes
                Correspondence: Qian Wang; Rui Tian, The Second Division of General Geriatrics, Department of Geriatrics, the First Affiliated Hospital of Zhengzhou University , No. 1 Eastern Jianshe Road, Erqi District, Zhengzhou, Henan, 450052, People’s Republic of China, Tel +8615838328873, Fax +8637166295183, Email qiansmile320@163.com; tianruiyfy@sina.com
                [*]

                These authors contributed equally to this work

                Article
                392519
                10.2147/CIA.S392519
                9844101
                36660542
                ea9c1885-9728-4df4-b9e6-f626d6e4af7e
                © 2023 Wang et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 07 October 2022
                : 04 January 2023
                Page count
                Figures: 1, Tables: 5, References: 25, Pages: 9
                Funding
                Funded by: Key Scientific and Technological Projects in the Department of Science and Technology of Henan Province;
                Funded by: Major Projects of Scientific and Technological Innovation 2030 “new generation of artificial intelligence” in China;
                This work was supported by the Key Scientific and Technological Projects in the Department of Science and Technology of Henan Province (grant number 222102310435 to QW) and the Major Projects of Scientific and Technological Innovation 2030 “new generation of artificial intelligence” in China (grant number 2021ZD0111001 to RT).
                Categories
                Original Research

                Health & Social care
                benign prostatic hyperplasia,lower urinary tract symptoms,renal function,elderly men,drug therapy

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