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Is benign prostatic hyperplasia a risk factor for chronic renal failure?
Andrew D Rule1, Michael M Lieber, Steven J Jacobsen
1Division of Nephrology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
The Journal of Urology
|February 16, 2005
Summary
Chronic renal failure (CRF) is a complication of benign prostatic hyperplasia (BPH). While the exact association is unknown, consider CRF in men with obstructive BPH or CRF, as prostate surgery can improve renal function.
Area of Science:
- Nephrology
- Urology
- Geriatrics
Background:
- Benign prostatic hyperplasia (BPH) and chronic renal failure (CRF) are prevalent in older men.
- Current guidelines do not recommend routine creatinine screening for BPH due to low trial prevalence.
- Obstructive BPH is a known cause of CRF.
Purpose of the Study:
- To review the literature on the association between BPH and CRF.
- To understand the relationship between lower urinary tract symptoms and renal decline.
Main Methods:
- A structured MEDLINE literature review was conducted.
- Studies published between 1966 and 2003 were analyzed.
- Focus on the association between BPH and CRF.
Main Results:
- Most studies were referral-based, limiting generalizability.
- Definitions of renal failure and urinary retention varied.
- Chronic retention, detrusor instability, and decreased bladder compliance were linked to CRF.
- Ureterovesicular junction obstruction was a proposed mechanism for CRF.
- Prostate surgery showed renal function improvement, but acuity was often unknown.
Conclusions:
- The precise extent of the BPH-CRF association remains unclear.
- More community-based observational studies are needed.
- An association exists and should be considered in clinical practice.