Estimated Glomerular Filtration Rate in Patients with Lower Urinary Tract Symptoms/Benign Prostatic Obstruction in an Emerging Tertiary Centre

Abstract

Background: The association of benign prostatic hypertrophy (BPH) and chronic kidney disease (CKD) has been a subject of controversies. Combinations of recurrent urinary tract infections, chronic retention with large residual urine volumes and decreased bladder compliance have been reported to be associated with chronic renal failure in patients with benign prostatic obstruction. Aims: To determine the estimated glomerular filtration rate (eGFR) and find out its relationship with the International Prostate Symptom Score (IPSS). Methodology: This is a cross-sectional study involving 129 new patients with benign prostatic hypertrophy. The severity and the degree of bother associated with patient’s lower urinary tract symptoms (LUTS) were assessed using the IPSS while the eGFR was determine using the modified Modification of Diets in Renal Disease. Results: Majority (38.8%) were in stage 2 CKD with eGFR of 60-89 ml/min/1.73 m2 and only 6(4.7%)  patients were in stage 5 CKD with eGFR <15 ml/min/1.73 m2. Overall 55(42.7%) were found to have CKD at presentation. There was no statistically significant difference between the severity of lower urinary tract symptoms (LUTS) and eGFR. The most observed symptom was urinary frequency followed by urgency which were present in 95 (73.6%) and 82 (63.6%) respectively. There was a significant difference in the quality of life among patient with eGFR less than or greater than 60 ml/min/1.73m2 p = .005. Conclusion: This study demonstrated an association between BPH and CKD in men whose symptoms were bothersome (those with poor QoL). The degree of bothersomeness (QoL) could be used as the determinant for requesting serum creatinine to assess the renal status of patient with BPH. Estimation of GFR among these patients with BPH will offer a rapid method of renal function assessment at presentation and thus facilitate the application of clinical practice guidelines and clinical performance measures to improve the outlook of possible renal complication.