Urine Problems
Even modest weight gain raises kidney disease risk
In healthy men of normal weight, relatively small increases in weight raise the risk of chronic kidney disease (CKD), according to a report by Korean researchers that will appear in the September issue of the Journal of the American Society of Nephrology.
The study, researchers say, suggests that CKD should be added to the list of conditions that are associated with weight gain, including diabetes and high blood pressure.
Obesity is a known risk factor for CKD, but the impact of weight gain in normal-weight individuals without high blood pressure or diabetes is unknown, Dr. Seungho Ryu, at Kangbuk Samsung Hospital in Seoul, and associates note in their report.
Tap water chemicals not linked to penis defect
Though some research has linked chemicals in chlorinated tap water to the risk of birth defects, a new study finds no strong evidence that the chemicals contribute to a common birth defect of the penis.
The defect, known as hypospadias, occurs when the urinary outlet develops on the underside of the penis rather than at the tip. Genetics are thought to play a large role in hypospadias risk, but the other potential causes are not fully understood.
Some past studies have suggested that certain chemicals in tap water—byproducts of the chlorination process used to kill disease-causing pathogens—may contribute to the risk of birth defects and miscarriage. Other studies, though, have found no such links.
Weight Gain Within the Normal Range Increases Risk of Chronic Kidney Disease
Healthy individuals who gain weight, even to a weight still considered normal, are at risk for developing chronic kidney disease (CKD), according to a study appearing in the September 2008 issue of the Journal of the American Society Nephrology (JASN). The study suggests that CKD should be added to the list of conditions that are associated with weight gain, including diabetes and hypertension.
Research has shown that obesity is linked to an increased risk of CKD, but no studies have looked at the effects of weight gain within the “normal” range of an individual’s body mass index. To investigate, Drs. Seungho Ryu and Yoosoo Chang of the Kangbuk Samsung Hospital in Seoul, Korea, and their colleagues conducted a prospective study of individuals who were of a healthy weight and had no known risk factors for chronic kidney disease.
In Korea, all workers participate in either annual or biennial health exams, as required by Korea’s Industrial Safety and Health Law. As a result, the investigators had access to clinical data from thousands of individuals. For this study, they included 8,792 healthy men who participated in the health exams in 2002.
Residual urine not tied to urinary infection
Among nursing home residents, incomplete bladder emptying is not associated with the occurrence of a urinary tract infection, according to a report in the Journal of the American Geriatrics Society.
It is generally assumed that residual urine after voiding increases the risk for urinary tract infection, “in that it creates an environment favorable to bacterial growth,” Dr. Esther Kuhry from Namsos Hospital, Norway told Reuters Health.
However, she explained, “The few studies published so far show conflicting results with regards to the association of post-void residual and urinary tract infection in the elderly.”
Weight, lifestyle factors tied to urinary symptoms
Adults who are obese or have less-than-ideal lifestyle habits may be more likely to have multiple, and more severe, urinary problems, new research suggests.
In a study of more than 5,500 men and women ages 30 to 79, researchers found that three-quarters of women and two-thirds of men reported at least one urinary tract symptoms—such as frequent trips to the bathroom overnight, difficulty emptying the bladder and urinary incontinence.
Obese adults were more likely than their normal-weight counterparts to have multiple, more severe symptoms. Smoking, lack of exercise and heavy drinking were also linked to more serious urinary problems.
Heart condition in those awaiting a kidney an ominous sign
The presence of an often silent heart condition—systolic dysfunction, or decreased pumping action of the heart—nearly doubles the risk of death for patients on kidney transplant waiting lists, according to a study appearing in the Journal of the American Society of Nephrology for June.
“This study identifies a subset of chronic kidney disease population at significantly higher risk for death while awaiting transplantation, where the role of medical interventions and devices such as implantable cardiac defibrillators and pacemakers should be studied,” Dr. Angelo M. de Mattos, from the University of California in Sacramento, and colleagues write.
Widely available tests could be used to help identify those patients with chronic kidney disease who have systolic dysfunction, they add.
Legislation needed to provide coverage for ED treatment after prostatectomy
Men who have developed erectile dysfunction (ED) following surgery for prostate cancer usually do not have insurance coverage for ED treatment even though their insurance policies cover surgery for prostate cancer, according to an analysis presented today at the 103rd Annual Scientific Meeting of the American Urological Association. In contrast, federal law requires that insurance companies which cover mastectomy for breast cancer treatment also cover breast reconstruction.
Erectile dysfunction (ED) is a common side effect of radical prostatectomy, though not always permanent, and almost all men experience some degree of ED following this surgery. The impact of ED on self-esteem and body image to prostate cancer patients can be as detrimental as the loss of a breast can be to a woman. However, the Women’s Health and Cancer Rights Act, passed by Congress in 1998, requires that third-party payers who cover mastectomy for breast cancer also cover the costs of breast reconstruction.
“There is compelling evidence that ED treatment leads to improved quality of life for the man and his partner,” said Ira D. Sharlip, M.D., a spokesman for the AUA. Therefore, as in the case of breast reconstruction for women, the cost of ED treatment should most certainly be covered for men.”
Poor kidney function tied to faster heart changes
People with decreased kidney function have faster progression of clogged arteries in the neck and increased risk of heart attack, stroke and other cardiovascular events, research indicates.
Dr. Michel Chonchol, of the University of Colorado Health Sciences Center, Denver, and colleagues examined associations between different levels of kidney disease, the thickness of neck arteries—an indicator of atherosclerosis (hardening of the arteries)—and cardiovascular events in 3364 individuals.
At the outset, 551 subjects (16.4 percent) had chronic kidney disease and the average thickness of the neck arteries, determined with ultrasound, was 0.79 mm. The average change in neck artery thickness was 0.02 mm/year.
Bladder trouble tied to depression, anxiety
Women who suffer from “dysfunctional voiding”—like having to urinate often and having difficulty voiding—experience a greater degree of depression and anxiety compared to women without these symptoms, research suggests.
“Dysfunctional voiding ... is more commonly seen in recent years,” Dr. Alex T. L. Lin, of Taipei Veterans General Hospital, Taiwan, told Reuters Health. “Although we suspect that depression and anxiety are reactions to the dysfunctional voiding, we could not preclude the possibility that psychological abnormalities might predispose one to the occurrence of lower urinary tract dysfunction,” he commented.
Lin noted that the stressful environment of modern society might be a contributing factor for the increased incidence of dysfunctional voiding.
Study Suggests Diet High in Saturated Fat Contributes to Prostate Cancer Treatment Failure
In the online version of the International Journal of Cancer, Dr. Sara Strom and associates evaluate the association between saturated fat intake and biochemical failure among men who underwent radical prostatectomy (RP).
A cohort of 390 patients who underwent radical prostatectomy at MD Anderson Cancer Center had a semi-quantitative validated Block food frequency questionnaire modified to their regional diets and completed for the year prior to the diagnosis of prostate cancer. Body mass index (BMI) was also calculated. Clinical and pathological data were abstracted from medical records. Categorical and continual variables were analyzed.
Aging Men Can Reduce Health Risks Through Physical Activity
Our results suggest that moderate to vigorous physical activity may reduce the risk of benign prostatic hyperplasia (BPH) or lower urinary tract symptoms (LUTS) by as much as 25% relative to a sedentary lifestyle. Although the strength of the association appears to be greater with higher levels of activity, there was a non-significant trend toward a protective effect with even light physical activity. Adjustment for multiple confounders in the studies included in this analysis underscores the independence of the protective effect of physical activity on the BPH/LUTS complex.
The notion that physical activity and other modifiable lifestyle factors may alter the risks and severity of BPH and LUTS challenges traditional etiological paradigms and intimates the need for the development of new pathogenic models for the BPH/LUTS disease complex. The assumption that BPH and LUTS are relatively immutable consequences of aging—driven by a combination of genetic predisposition, androgens, and estrogens—underpins prior models. While genotype and hormones are important components, the relationship of physical activity with BPH/LUTS demands consideration of additional modulators of these processes.
It is possible that physical activity influences prostate growth pathways through alterations in hormone levels. However, we believe a more likely explanation is that physical activity exerts beneficial effects through improved cardiovascular health.
Creatinine Increase in Elderly Means Increased Renal Disease, Mortality
Even small increases in serum creatinine levels during hospitalization raise the risk of end stage renal disease and mortality of elderly patients over the long term, according to a University of Alabama at Birmingham (UAB) study in the Archives of Internal Medicine.
The 10-year retrospective study, led by UAB nephrologist Britt Newsome, M.D, is the first systematic description of creatinine increase and longer-term end stage renal disease and mortality risk. Previous studies showed a relationship between reductions in kidney function during hospitalization and higher mortality rates.
“Previous studies have shown that a rise in serum creatinine level of 0.3 milligrams per deciliter or more during hospitalization is associated with higher in-hospital mortality, longer stays and higher costs,” Newsome said. “However, little was known about the long-term risks of subsequent end-stage renal disease and mortality in this population. The long-term risks we observed suggest that even the least severe category of kidney injury may indicate a worse prognosis.”
Reason for cystic fibrosis infections uncovered
People with cystic fibrosis are prone to lung infections, especially with the bug Pseudomonas aeruginosa, and now a German team has discovered why. Their experiments with mice show that the accumulation of a fatty substance called ceramide in the respiratory tract is the reason.
The good news is that one enzyme, dubbed Asm, is in large part responsible for this build-up, so treatment aimed at blocking this enzyme might reduce lung infections in people with CF.
The underlying cause of the disease cystic fibrosis is known to be a gene mutation, but how this promotes lung infections was unclear.
Men Seeking Vasectomy Reversals Can Expect High Rates of Success
This retrospective study compared postoperative semen analysis parameters and patency rates of vasovasostomy performed in the convoluted versus straight portion of the vas deferens. This study was undertaken to assess whether or not the perceived increased technical difficulty that may be encountered resulted in a change in success rates.
Patient age, partner age, obstructive interval, gross and microscopic appearance of the intraoperative fluid aspirated from the testicular portion of the vas deferens, and postoperative semen analysis results were examined. Patency was defined as any sperm in the postoperative ejaculate and was compared for the 2 groups.
There were no significant differences in the postoperative semen analysis parameters of volume, total count, sperm density, motility or total motile count between the 2 groups. The patency rate was 98.1% and 97.3% for convoluted vasovasostomy and straight vasovasostomy, respectively, and was not statistically different.
Study finds bacteria may reduce risk for kidney stones
Researchers from Boston University’s Slone Epidemiology Center have found that the bacteria Oxalobacter formigenes (O. formigenes), a naturally occurring bacterium that has no known side effects, is associated with a 70 percent reduction in the risk of recurrent kidney stones. These findings appear online in the March issue Journal of the American Society of Nephrology.
Kidney stones are an important health problem in many countries. In the United States, the lifetime risk for developing a stone is five to 15 percent, and a five-year risk for recurrence is 30 to 50 percent. The economic impact of hospital admissions for this condition is $2 billion per year.
According to the researchers, up to 80 percent of kidney stones are predominately composed on calcium oxalate (CaOx) and urinary oxalate is a major risk factor for CaOx stone formation. O. formigenes metabolizes oxalate in the intestinal tract and is present in a large proportion of the normal adult population.
