Factors associated with low-compliance bladder in end-stage renal disease patients and development of a clinical prediction model for urodynamic evaluation: the DUDi score

Abstract

Objectives To investigate factors associated with low-compliance bladders (LCB) in pretransplant patients with end-stage renal disease (ESRD) and develop a clinical prediction model for urodynamic studies. Methods This study was a prospective cohort study. Patients with ESRD on the renal transplantation waiting list were recruited and underwent the urodynamic study. Demographics data, predictor factors related to the bladder compliance such as underlying disease of the lower urinary tract disease (LUTD), duration of urine < 250 mL/day, type and duration of renal replacement therapy (RRT), urine volume per day and urodynamic study information were collected. Univariable and multivariable logistic regression models were used to assess the independence of explanatory factors, then we developed the clinical prediction model. Results One hundred fifty-two patients participated in the study: 94 patients in the normal bladder group and 58 patients in LCB group. Demographic data were not significantly different between the two groups, except diabetes. Cystometric capacity, detrusor pressure, compliance were significantly different. From the univariate analysis, DM status, duration of RRT, and passing < 100 mL of urine per day were related to LCB. We named the prediction model, the DUDi score based on the predictors ( D uration of RRT, U rine volume/day, Di abetes). Higher scores predicted a higher risk of low-compliance bladder [ P value = 0.464 according to the Hosmer–Lemeshow test, and the AUC was 0.87 (95% CI 0.81–0.92)]. Conclusions Our clinical prediction model is easy to use and provides a high predictive value that is appropriate for patients who have no known LUTD to identify low-compliance bladder. Trial registration number and date of registration for prospectively registered trials This study was approved by the Thai Clinical Trials Registry Committee on 09 February 2021. The TCTR identification number is TCTR20210209006.

„Pressure kills kidneys“: Schutz des oberen Harntrakts durch neuro-urologisches Management

“…Andere Faktoren, die eine LC hervorrufen und sich histopathologisch unterscheiden, sind sekundär radiogene Veränderungen [6,7] der Harnblase oder Schrumpfungsvorgänge, wie sie bspw. habituell oder bei anurischen Patienten vorkommen können [8]. BCG-induzierte Zystitiden können bei einem Teil der so behandelten Patienten ebenfalls zu einer LC führen [9].…”

Urodynamics in the Transplant Population

“…Researchers have attempted to define the appropriate, high-yield pre-KT population that would benefit from UDS testing. For example, Tangpaitoon et al recently looked at factors associated with low compliance bladders to identify clinical predictors for urodynamic evaluation [10]. Of 152 ESRD patients prospectively recruited to undergo UDS, 94 were found to have normal bladders and 58 had low-compliance bladders.…”