Korean J Intern Med.  2015 Jan;30(1):82-87. 10.3904/kjim.2015.30.1.82.

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

• Cho JA
• Cho ST
• Lee YK
• Oh J
• Kim SG
• Seo JW
• Yoon JW
• Koo JR
• Kim HJ
• Lee YS
• Lee YG
• Noh JW

• KMID: 2129667
• DOI: http://doi.org/10.3904/kjim.2015.30.1.82

Abstract

BACKGROUND/AIMS
Diabetic cystopathy is a frequent complication of diabetes mellitus. This study assessed the association between the post-voiding residual (PVR) urine volume and diabetic nephropathy in type 2 diabetics with no voiding symptoms.
METHODS
This study investigated 42 patients with type 2 diabetes who were followed regularly at our outpatient clinic between July 1, 2008 and June 30, 2009. No patient had voiding problems or International Prostate Symptom Scores (IPSSs) > or = 12. An urologist performed the urological evaluations and the PVR was measured using a bladder scan. A PVR > 50 mL on two consecutive voids was considered abnormal, which was the primary study outcome.
RESULTS
The mean patient age was 60 +/- 10 years; the IPSS score was 3.7 +/- 3.3; and the diabetes duration was 11.9 +/- 7.8 years. Seven of the 42 patients (16.7%) had a PVR > 50 mL. The presence of overt proteinuria or microalbuminuria was associated with 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) compared with those with a PVR < or = 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 significant risk factor for a PVR > 50 mL.
CONCLUSIONS
Patients with diabetic nephropathy had a significantly higher PVR and a lower eGFR was associated with an abnormal PVR.

Keyword

Diabetic nephropathies; Diabetes complications; Diabetes mellitus; Residual volume

MeSH Terms

Adult
Aged
Aged, 80 and over
Diabetes Mellitus, Type 2/*complications/diagnosis
Diabetic Nephropathies/diagnosis/*etiology/physiopathology
Female
*Glomerular Filtration Rate
Humans
Kidney/*physiopathology
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Outpatient Clinics, Hospital
Republic of Korea
Risk Factors
Time Factors
*Urodynamics