International Urology and Nephrology最新文献

{"title":"Estimated glucose processing rates and the association of chronic kidney disease and proteinuria in non-diabetic adults.","authors":"Hao Zhou, Xuanwen Ru, Simiao Chen, Qing Ye","doi":"10.1007/s11255-025-04448-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04448-8","url":null,"abstract":"<p><p>The study, which was based on NHANES data (1999-2018), included 21,234 nondiabetic individuals aged 20 years and older to investigate the associations between the estimated glucose disposal rate (eGDR) and the risk of chronic kidney disease (CKD) and proteinuria. CKD was defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m², and proteinuria was defined as a urinary albumin-to-creatinine ratio (UACR) exceeding 30 mg/g. The results demonstrated a significant inverse association between eGDR levels and the risks of CKD and proteinuria. After adjusting for potential confounders, the association between eGDR and CKD showed that, compared with those for Q1, the adjusted odds ratios (ORs) for Q2, Q3, and Q4 were 0.82 (95% CI: 0.61-1.11), 0.62 (95% CI: 0.39-0.98), and 0.55 (95% CI: 0.28-1.05), respectively. For the relationship between eGDR and proteinuria, the adjusted ORs for Q2, Q3, and Q4 were 0.54 (95% CI: 0.42-0.69), 0.41 (95% CI: 0.27-0.62), and 0.65 (95% CI: 0.43-0.98), respectively. Moreover, each standard deviation increase in eGDR was associated with a 9% reduction in CKD risk (OR: 0.91, 95% CI: 0.85-0.98) and a 13% reduction in proteinuria risk (OR: 0.87, 95% CI: 0.82-0.93). Further adjustments via restricted cubic spline (RCS) regression analysis revealed a significant nonlinear relationship between eGDR and CKD and a U-shaped relationship between eGDR and proteinuria. A lower risk of proteinuria was observed when eGDR levels were between 8.70 and 9.91. These findings, combined with those of previous studies, suggest that eGDR may serve as a potential alternative metric for insulin resistance (IR). In nondiabetic individuals, the eGDR was significantly associated with the risk of CKD and proteinuria, with a notable nonlinear pattern in these relationships.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating biomarker clustering for improved diagnosis of interstitial cystitis/bladder pain syndrome: a review.","authors":"Yu-Chen Chen, Hann-Chorng Kuo","doi":"10.1007/s11255-025-04452-y","DOIUrl":"10.1007/s11255-025-04452-y","url":null,"abstract":"<p><p>Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating chronic condition characterized by pelvic pain and urinary disturbances, making its diagnosis challenging due to overlapping symptoms with various lower urinary tract disorders. Current diagnostic methods primarily rely on subjective evaluations, leading to significant difficulties in accurately identifying and managing IC/BPS. This review explores the potential of clustering different disease biomarkers to enhance diagnostic precision for IC/BPS. We examine current research identifying non-invasive biomarkers, including inflammatory markers, oxidative stress indicators, and neurogenic growth factors, while emphasizing the limitations inherent in single biomarker approaches. By employing cluster analysis, which integrates diverse biomarker data relevant to IC/BPS, current studies indicate that this integration facilitates improved sensitivity and specificity in diagnosis while enabling personalized treatment strategies. Emerging machine learning techniques further enhance this analytical framework, identifying predictive urinary biomarkers that can assist frontline clinicians in making informed diagnostic decisions. This review also highlights the need for standardized protocols in biomarker collection and analysis, advocating for multi-omics integration and longitudinal studies to uncover disease mechanisms and improve clinical practices. Ultimately, utilizing a cluster of disease biomarkers aims to provide objective diagnostic tools, thereby supporting clinicians in delivering timely and effective interventions that can significantly impact patients' quality of life.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic lymph nodes outside the extended lymphadenectomy template correlate with advanced staging but not grading in prostate cancer patients undergoing radical prostatectomy.","authors":"Jakub Karwacki, Agnieszka Mioskowska, Paulina Tomecka, Krystian Mączka, Adam Gurwin, Maximilian Kobylański, Agnieszka Hałoń, Przemysław Szuba, Romuald Zdrojowy, Tomasz Szydełko, Bartosz Małkiewicz","doi":"10.1007/s11255-025-04450-0","DOIUrl":"https://doi.org/10.1007/s11255-025-04450-0","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the impact of metastatic lymph nodes (LNs) outside the extended pelvic lymph node dissection (ePLND) template on oncological outcomes, staging, grading, and concomitant parameters in prostate cancer (PCa) patients undergoing radical prostatectomy (RP).</p><p><strong>Methods: </strong>Data from 860 patients with histologically confirmed, non-metastatic PCa who underwent RP between 2012 and 2022 were retrospectively analyzed. All specimens underwent detailed histopathological examination. Preoperative and postoperative clinicopathological data were collected and analyzed. Subgroup associations were evaluated using the Mann-Whitney U test and the Kruskal-Wallis test. Kendall's tau-b coefficient was employed to evaluate the association between two variables. All tests were performed using a two-tailed approach, with a p value of less than 0.05 considered statistically significant for differences between groups. Kaplan-Meier and Cox regression analyses assessed biochemical recurrence (BCR)-free survival based on lymph node invasion (LNI) (pN0 vs. pN1) and the presence of metastatic LNs outside the ePLND template.</p><p><strong>Results: </strong>Of the 860 patients, 613 underwent modified-ePLND. Among them, 122 (19.9%) were pN1, with 22 patients (18%) having metastatic LNs located outside the classical ePLND template. Patients with LNs beyond the ePLND template exhibited higher clinical T stages (p = 0.016) and a greater percentage of positive biopsy cores (p = 0.008). However, no correlation was observed with Gleason Grading Group (p = 0.491). Kaplan-Meier analysis showed that pN1 patients had higher BCR rates compared to pN0 patients, but this difference did not reach statistical significance (p = 0.174). Similarly, patients with metastatic LNs outside the ePLND template demonstrated a trend toward increased BCR risk, though this was not statistically significant (p = 0.140).</p><p><strong>Conclusion: </strong>Metastatic LNs beyond the ePLND template correlate with more advanced tumor staging in PCa. However, they show no association with tumor grading. Their influence on BCR remains inconclusive, likely due to the small number of patients included in the BCR-associated analyses. Extended lymphadenectomy may enhance staging accuracy but must be weighed against the potential for increased surgical morbidity.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the choice of urethral slings over artificial sphincter for male stress urinary incontinence.","authors":"Zachary Boston, Kunj Jain, Hassan Choudhry, Meher Pandher, Aleksandar Popovic, Amjad Alwaal","doi":"10.1007/s11255-025-04444-y","DOIUrl":"https://doi.org/10.1007/s11255-025-04444-y","url":null,"abstract":"<p><strong>Objective: </strong>To examine the factors influencing urologists' decision to offer slings instead of AUS for managing male stress urinary incontinence.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database 2006-2021 was used to identify patients undergoing surgical procedures for male urinary incontinence using current procedural terminology (CPT) codes. The Current procedural terminology (CPT) codes for AUS (53,445) and male slings (53,440) were used to analyze the data appropriately. The cases with incomplete demographic data were excluded. Patient characteristics of interest were race, age, smoking status, obesity, HTN, COPD, ASA classification, use of glucocorticoids, history of cancer, and diabetes mellitus. Chi square and multivariate logistic regressions were used to identify significant predictors of outcomes. Significance was defined as p<0.05.</p><p><strong>Results: </strong>Among 4098 patients, 2407 underwent AUS implantation, and 1691 received a sling for male SUI. African American males were significantly more likely than Caucasian males to receive a sling (OR = 5.566, p < 0.05). The patients with comorbidities such as diabetes mellitus, hypertension, use of glucocorticoids, cancer, increased ASA, and history of DVTs are significantly more likely to undergo sling placement. COPD, congestive heart failure, and dialysis had no impact on the choice of male urinary incontinence management.</p><p><strong>Conclusion: </strong>Male patients who are African American or have comorbidities such as history of diabetes, hypertension, cancer, DVT, and glucocorticoid use were more likely to be offered slings for stress urinary incontinence. These findings suggest a preference among urologists to recommend slings for patients with higher surgical risk profiles.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary kidney stone analysis composition among U.S. adults and children in a large reference laboratory setting.","authors":"Kelly Lehner, Patrick Day, Joshua Bornhorst, Paul Jannetto, John Lieske, Kevin Koo","doi":"10.1007/s11255-025-04453-x","DOIUrl":"https://doi.org/10.1007/s11255-025-04453-x","url":null,"abstract":"<p><strong>Objectives: </strong>To provide updated population-level data on stone composition by characterizing changes in the prevalence of kidney stone composition by patient age, gender, and geographic location using data from a large tertiary stone analysis laboratory.</p><p><strong>Methods: </strong>The [redacted for anonymity] receives kidney stone specimens for analysis by infrared spectroscopy. All stones submitted over a 12-month period (December 2022-November 2023) are included in this report. Stone characteristics were analyzed together with patient age, gender, and geographic location.</p><p><strong>Results: </strong>85,273 stones were analyzed. The rate of stone submission did not vary significantly by month (p = 0.37). Stones were more commonly from the male (55.5%) versus female patients. However, women made up a greater proportion of stone submissions aged 12-50 (53.9%). Individuals < 30 years of age made up 7.3% of stone submissions and had a significantly higher incidence of calcium phosphate stones (p < 0.05). Rare drug or metabolite stone submissions (0.04%) included xanthine, guaifenesin, triamterene, atazanavir, and N4-acetyl-sulfamethoxazole.</p><p><strong>Conclusions: </strong>In contrast to previous findings, no difference in the prevalence of various stone types was observed by month of year. This may reflect evolving climate patterns, and warrants continued attention. The gender gap between men and women for stone formation is seen to be closing, with women submitting the majority of stones from individuals less than 50 years old. Whether this trend will persist as these women age in coming decades will be an important area of future study of stone epidemiology.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted versus laparoscopic adrenalectomy for large adrenal tumors: a systematic review and meta-analysis.","authors":"Shaolong Zhang, Chuanjian Chen, Chunhao Mo, Zhuoxi Pei, Zhichun Dong, Zhongyun Ning, Zizhen Hou, Hui Ding","doi":"10.1007/s11255-025-04442-0","DOIUrl":"https://doi.org/10.1007/s11255-025-04442-0","url":null,"abstract":"<p><strong>Background: </strong>The application of robotic adrenalectomy (RA) is increasing. However, there is still controversy over whether RA is more feasible than laparoscopic adrenalectomy (LA) for large adrenal tumors (LATs).</p><p><strong>Methods: </strong>This meta-analysis compares the efficacy and safety of RA versus LA for LATs. A systematic literature search of PubMed, the Cochrane Library, Embase, CNKI, WANFANG database, and other databases (up to December 2024) was performed to identify studies comparing RA and LA. Data were analyzed using the Cochrane Collaboration's Review Manager (RevMan) 5.3 software.</p><p><strong>Results: </strong>Overall, eight studies with 601 patients were included in the analysis. There were no statistically significant differences between the two groups in operative time (SMD = -0.65, 95% CI -1.48 to 0.18; P = 0.12), transfusion rate (OR = 1.12, 95% CI 0.59 to 2.16; P = 0.73), hemodynamic instability (OR = 0.67, 95% CI 0.23 to 1.92; P = 0.46), postoperative transfer to SICU (OR = 1.26, 95% CI 0.15 to 10.51; P = 0.83). Patients from the RA group could benefit from less occurrence of conversion to open (OR = 0.18, 95% CI 0.05 to 0.59; P = 0.005), lower EBL (SMD = -1.11, 95% CI -1.71 to -0.52; P = 0.0002), quicker time to removal of drainage (SMD = -1.12, 95% CI -2.03 to -0.21; P = 0.02), and shorter length of hospital stay (SMD = -1.61, 95% CI -2.41 to -0.81; P < 0.0001, I² = 94%). Meanwhile, it should be noted that the RA group produces higher cost compared to the LA group (SMD = 24.12, 95% CI 12.96 to 35.29; P < 0.0001, I² = 99%).</p><p><strong>Conclusions: </strong>Compared to LA, RA has higher advantages in certain aspects. RA is an effective and safe treatment option for LATs.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injection of platelet-rich plasma combined with dexamethasone with visual internal urethrotomy in treating short bulbar urethral stricture.","authors":"Ahmed Mahmoud Reyad, Ahmed Mahmoud Mohammed, Tarek Ahmed Mahmoud, Ahmed Mahmoud Hasan, Atef Fathi, Ahmed Mamdouh Abd Elhamed","doi":"10.1007/s11255-025-04433-1","DOIUrl":"https://doi.org/10.1007/s11255-025-04433-1","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long-term urethral patency of short bulbar urethral stricture management using visual internal urethrotomy with platelet-rich plasma (PRP) in conjunction with dexamethasone injection.</p><p><strong>Methods: </strong>This retrospective study included 78 male patients with symptomatic short bulbar urethral stricture (diagnosed by ascending urethrography) who were treated by internal urethrotomy after injection of submucosal PRP combined with dexamethasone. Every patient was monitored for urethral stricture recurrence one month after catheter removal and twenty-four months after internal urethrotomy.</p><p><strong>Results: </strong>The etiology of urethral stricture was iatrogenic in 63 (80.8%) patients, inflammatory in 9 (11.5%) patients, and idiopathic in 6 (7.7%) patients. In terms of complications, two patients (2.7%) experienced bleeding per urethra, four patients (5.4%) had fever, three patients (4%) had hematuria, one patient (1.4%) had perineal abscess, and seven patients (9.5%) had a recurrence of stricture. The etiology of the stricture did not have any significance in patients who experienced recurrence (P = 0.77).</p><p><strong>Conclusions: </strong>Our findings suggest a potential protective effect of PRP and dexamethasone injection at the time of internal urethrotomy also decreased the length of stricture in case of recurrence. This protective effect lasted for at least 2 years.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemotherapy-enhanced endoscopic submucosal En Bloc dissection vs. conventional TURBT for NMIBC: a comparative study.","authors":"Xi Liu, Yiding Wang, Zhe Wang, Bo Shao, Qiang Liu, Changqi Li, Chengcheng Lv, Huan Bi, Guangyi Shan, Shui Fu, Ang Chen, Yu Zeng","doi":"10.1007/s11255-025-04446-w","DOIUrl":"https://doi.org/10.1007/s11255-025-04446-w","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of integrating en bloc resection, endoscopic submucosal dissection (ESD), and submucosal injection of chemotherapeutic agents with TURBT (cESD-TURBT).</p><p><strong>Methods: </strong>This retrospective observational study was conducted on patients diagnosed with stage cTa-T1 bladder cancer who received TURBT between December 2020 and July 2023 at Liaoning Cancer Hospital. The participants were grouped on the basis of the type of treatment they received: cESD-TURBT (n = 118) or conventional TURBT (cTURBT, n = 105). Hydroxycothecin is the chemotherapeutic agent used for submucosal injections. The primary outcome was the recurrence-free survival (RFS) of the treated patients with bladder cancer. The secondary outcomes included disease recurrence within one year, operation duration, length of postoperative hospitalization, and complication rates. Statistical analyses were performed via appropriate tests, with a threshold of P < 0.05 defined as statistically significant.</p><p><strong>Results: </strong>Compared with the cTURBT cohort, the cESD-TURBT cohort demonstrated increased RFS, with a median follow-up of 775 days (interquartile range [IQR] 414-1040). The recurrence rate in the cESD-TURBT cohort was 18.6% (22/118), whereas it was 39.1% (41/105) in the cTURBT cohort, with a log-rank hazard ratio of 0.49 (95% CI 0.29-0.82; p = 0.0053). Furthermore, cESD-TURBT resulted in fewer postoperative complications than did cTURBT, markedly reducing the occurrence of complications, such as the obturator reflex (1.7% vs. 8.6%, p = 0.03). The difference in operation time was not statistically significant, with a cESD-TURBT of 49.0 ± 21.0 min and a cTURBT of 44.3 ± 23.8 min (p = 0.127).</p><p><strong>Conclusion: </strong>Our analysis revealed that, compared with cTURBT, cESD-TURBT significantly lowers recurrence rates and is associated with fewer postoperative complications. Our study revealed that cESD-TURBT is superior to cTURBT for bladder tumor removal.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global burden of chronic kidney disease due to glomerulonephritis: trends and predictions.","authors":"Xiaotong Wang, Zhaoyi Liu, Na Yi, Liguo Li, Li Ma, Linyue Yuan, Xuejiao Wang","doi":"10.1007/s11255-025-04440-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04440-2","url":null,"abstract":"<p><strong>Background: </strong>Glomerulonephritis (GN), one of the primary causes of chronic kidney disease (CKD), is gaining recognition as a major public health issue. This research sought to evaluate the worldwide impact of chronic kidney disease due to glomerulonephritis (GN-CKD) between 1990 and 2021 and to forecast trends up to 2036, leveraging data from the Global Burden of Disease (GBD) study.</p><p><strong>Methods: </strong>The analysis of GN-CKD from 1990 to 2021 utilized GBD open data as a secondary dataset to examine global prevalence, deaths, disability-adjusted life years (DALYs), and age-standardized rates of GN-CKD, and the changing trends of these indicators were statistically analyzed. To assess the practical difference between each country/region and the frontier, we utilized the 2021 DALYs and Socio-Demographic Index (SDI). To assist healthcare institutions in formulating more effective public health policies, the age-standardized mortality and DALYs rate until 2036 were predicted using Bayesian age-period-cohort (BAPC) modeling techniques.</p><p><strong>Results: </strong>The global prevalence rate of GN-CKD, as indicated by the age-standardized prevalence rate (ASPR), grew 10.81% between 1990 and 2021, with a marginal average annual change of 0.04 (AAPC0.04, 0.03-0.05). Similarly, there was an increase of 15.84% in the age-standardized death rate (ASDR) for GN-CKD during this period, with an average annual trend of 0.50 (AAPC0.50, 0.41-0.59). Moreover, the age-standardized DALYs rate (ASYR) for GN-CKD observed an upward trend of 8.60% from 1990 to 2021, with a modest average annual change of 0.27 (AAPC0.27, 0.17-0.37). Our findings indicate that the impact of GN-CKD differs across gender, geographic areas, and socioeconomic statuses. Elevated fasting plasma glucose levels, high body-mass index (BMI), and elevated systolic blood pressure were the main contributors to deaths and disability-adjusted life years (DALYs). Fortunately, the burden of GN-CKD is expected to diminish by 2036.</p><p><strong>Conclusions: </strong>The worldwide impact of GN-CKD has risen, with variations observed between genders and across SDI regions. Encouraging trends point toward a potential reduction in GN-CKD-related burden in the future.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical predictors of bladder outlet obstruction in men consulting for routine urological screening.","authors":"Massimiliano Raffo, Paolo Capogrosso, Edoardo Pozzi, Federico Belladelli, Christian Corsini, Alessandro Bertini, Fausto Negri, Luigi Candela, Alessandro Larcher, Rayan Matloob, Alessia d'Arma, Francesco Montorsi, Andrea Salonia","doi":"10.1007/s11255-025-04432-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04432-2","url":null,"abstract":"<p><strong>Purpose: </strong>Lower urinary tract symptoms (LUTS) associated with bladder outlet obstruction (BOO) are prevalent among men, notwithstanding being self-underreported. We aimed to assess the predictors for BOO during first visit.</p><p><strong>Methods: </strong>Data from 1045 analyzed men older than 40 years attending a single urological institution from 2010 to 2021. The men diagnosed with BOO, prostate cancer or any treatment for BOO were excluded. The patients completed the International Prostatic Symptoms Score (IPSS) and were investigated with prostate-specific antigen (PSA), trans-rectal ultrasound to measure prostate volume (PV) and free uroflowmetry. Logistic regression analysis tested the association between parameters and BOO. The area under the curve compared the diagnostic accuracy of predictors. The Youden-index analysis defined the cut-off predicting LUTS.</p><p><strong>Results: </strong>Of 1045 patients, the median (IQR) age was 62 (51-69) years. A total of 773 (74%) had moderate LUTS. Both PV (OR: 1.16; 95%CI 1.04-1.3; p = 0.005) and IPSS (OR: 1.06; 95%CI 1.03-1.08; p < 0.001) were associated with BOO after adjusting for age. They showed a predictive accuracy with an AUC of 0.69 (0.60-0.77) and 0.63 (0.59-0.67) for PV and IPSS, respectively. A PV of 43 mL emerged as the cut-off point to define the risk of BOO. Therefore, a 60-year man with a PV ≥ 43 mL showed an 84% (70-90) risk of BOO as compared with 59% (50-68) for a same age man with lower PV.</p><p><strong>Conclusion: </strong>Men older than 40 years should be screened for LUTS associated with BOO since they are highly prevalent. User-friendly parameters such as PV and IPSS could guide further investigation of BOO.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}