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Published in: International Urology and Nephrology 8/2016

01-08-2016 | Nephrology - Original Paper

Urinary incontinence and diuretic avoidance among adults with chronic kidney disease

Authors: Mitul Patel, Kavitha Vellanki, David J. Leehey, Vinod K. Bansal, Linda Brubaker, Robert Flanigan, Julia Koval, Anuradha Wadhwa, Neelam Balasubramanian, Jasmin Sandhu, Holly Kramer

Published in: International Urology and Nephrology | Issue 8/2016

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Abstract

Purpose

Diuretics remain an important medication for hypertension management among adults with chronic kidney disease (CKD), but diuretics may also worsen urinary symptoms, especially urinary incontinence (UI). This single-center pilot study examined the prevalence of UI among adults age ≥60 years with CKD using diuretics and assessed diuretic avoidance due to urinary symptoms.

Methods

Patients with non-dialysis-dependent CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2) and diuretic use were recruited from outpatient nephrology clinics. Urinary symptoms and diuretic avoidance were assessed using standardized questionnaires.

Results

The cohort of 44 women and 54 men had a mean age of 71.8 (8.4) years, and urgency-UI, stress-UI and mixed-UI (the presence of both urgency-UI and stress-UI) were reported by 44.9 % (n = 44), 36.7 % (n = 36) and 26.5 % (n = 26), respectively. Nocturia was noted in 68 % (n = 67). Overall, 15.3 % (6 men and 9 women) reported diuretic avoidance. Avoidance of diuretics was 27.3 % (n = 12), 25.5 % (n = 9) and 34.6 % (n = 9) among participants with urgency-UI, stress-UI and mixed-UI, respectively, while only 6.8 % (n = 3) of participants without any UI reported diuretic avoidance. After adjusting for age, sex and diuretic type (loop vs. others), both urgency-UI (odds ratio 5.9 95 % CI 1.5–22.8) and mixed-UI (odds ratio 5.7; 95 % CI 1.6–19.9) were significantly associated with diuretic avoidance compared to participants without urgency-UI, or mixed-UI, respectively. Stress-UI and nocturia were not significantly associated with diuretic avoidance.

Conclusions

UI is common among older adults with CKD receiving diuretics. Patients with urgency-UI are more likely to avoid diuretics.
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Metadata
Title
Urinary incontinence and diuretic avoidance among adults with chronic kidney disease
Authors
Mitul Patel
Kavitha Vellanki
David J. Leehey
Vinod K. Bansal
Linda Brubaker
Robert Flanigan
Julia Koval
Anuradha Wadhwa
Neelam Balasubramanian
Jasmin Sandhu
Holly Kramer
Publication date
01-08-2016
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 8/2016
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-016-1304-1

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