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Men with obstruction resulting from benign prostatic hyperplasia (BPH)
are three times more likely to develop chronic kidney disease.
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ROCHESTER, Minn. -- Men who experience signs and symptoms
of a prostate obstruction resulting from benign prostatic
hyperplasia (BPH) are three times more likely than other men
to develop chronic kidney disease, according to findings of
a Mayo Clinic study published in this month's edition of
Kidney International.
"This is the first study on the topic to sample the general
community," says Andrew Rule, M.D., the Mayo Clinic kidney
specialist who conducted the study with epidemiologist Steven
Jacobsen, M.D., Ph.D.
"Symptomatic and non-symptomatic men were compared, unlike
clinical trials and studies in a urology practice, which tend to
represent only symptomatic men."
BPH and chronic kidney disease pose significant health problems
in older men. Chronic kidney disease (CKD) occurs when the kidneys
cannot rid metabolic wastes from the body or maintain the proper
fluid and chemical balances. Eventually, the waste builds up and
becomes poisonous to the body. Kidney disease can develop rapidly -
in two to three months - or gradually over decades.
Many risks coincide with the development of CKD. "Several studies
show men with chronic kidney disease have increased chance of death,
hospitalization and cardiovascular events," says Dr. Rule.
The prostate gland is located just below a male's bladder and
surrounds the top portion of the urethra, the tube that drains urine
from the bladder. "Growth of the prostate gland can lead to a
bladder outlet obstruction," says Dr. Rule. "An obstruction of the
bladder can cause inability to or discomfort in emptying the
bladder, a slowed stream of urine, frequent urges to void during the
night or an enlarged, damaged bladder."
"We were surprised at how much kidney disease can be attributed
to BPH," says Dr. Jacobsen. "An obstruction on the urethra is like a
dam on a river - men can still void, but the constant buildup and
pressure will ultimately cause damage." BPH affects about half of
men in their 60s and up to 90 percent of men in their 70s and 80s.
It is not related to the development of prostate cancer, although
causes of BPH tissue growth inside the prostate later in life is
unclear. Researchers believe that with age the prostate becomes more
susceptible to the effects of hormones, including testosterone.
The most effective way to treat CKD is to care for and manage the
underlying disease. "It has been shown that many patients with
kidney disease respond to surgical treatments of BPH," says Dr.
Rule. "There are also medications to relieve obstructions, by either
shrinking the prostate gland or relaxing muscles that contribute to
the obstruction."
The recent study surveyed 476 white men, ages 40-79, randomly
selected from Olmsted County, Minn. Eventually, the researchers
would like to see if similar findings are reproduced among general
populations studied at other research centers. Dr. Jacobsen also
suggests further research and testing to determine if treating BPH
reverses the progression of kidney disease.
Ultimately, the researchers hope the results of the study will
encourage both physicians and patients to consider BPH as a factor
in kidney disease. "Men with diagnosed BPH may need to be screened
to see if this condition is causing kidney damage," says Dr.
Jacobsen.
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