Urinary incontinence and diuretic avoidance among adults with chronic kidney disease Journal Article

Authors: Patel, M; Vellanki, K; Leehey, D. J.; Bansal, V. K.; Brubaker, L; Flanigan, R; Koval, J; Wadhwa, A; Balasubramanian, N; Sandhu, J; Kramer, H
Article Title: Urinary incontinence and diuretic avoidance among adults with chronic kidney disease
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.
Journal Title: International urology and nephrology
ISSN: 1573-2584; 0301-1623
Publisher: Unknown  
Date Published: 2016
Language: ENG
Notes: LR: 20160522; JID: 0262521; OTO: NOTNLM; 2016/04/21 [received]; 2016/04/23 [accepted]; 2016/05/21 [aheadofprint]; aheadofprint