#885 Urodynamic finding and urinary symptoms in patienmts undergoing hemodialysis

Abstract Background and Aims Lower urinary tract symptoms (LUTS) affect patients with chronic kidney disease (CKD) undergoing hemodialysis (HD). These symptoms reduce the quality of life and can be responsible for severe complications. Furthermore, patients on waiting list for kidney transplantation that are not adequately treated risk to develop functional damages to the graft in case of transplant. We investigated LUTS in patients attending our HD center and explored their urodynamic (UD) outcomes. Method From January 2022 to July 2024, clinical, laboratory, and UD outcomes have been extracted from two electronic database systems of our HD center. The following symptoms were assessed: urinary urgency and frequency, nocturia, urinary incontinence, urinary burning, poor voiding flow, haematuria, bladder pain. Prevalence of symptoms in the population was assessed, and correlation with UD findings was explored. Demographic data were evaluated by the Student T test; Chi-Square test was applied for nominal data. Correlation between type of symptoms, patients’ age, dialytic age, were calculated using the Spearman correlation test. Results A total number of 199 patients (101 males, 98 females) has attended our HD center during the time interval of this investigation. Patients were caucasian, mean age was 71,4 (range 20–86) years. Mean dialytic time of the cohort resulted 51.4 months (range 4–78). Dialytic age and mean age did not significantly differ between sexes. Anuric individuals were 45% of the cohort diaries. The following symptoms were reported (as number of events): urinary burning (122), urinary frequency (108), urinary urgency (102), nocturia (67), poor voiding flow (52), hematuria (39), urinary incontinence (22), pelvic pain (11). The total number of events caused by LUTS was 523 and represented the third reason for seeking medical assistance by these patients in the time interval of this study, if compared with cardiovascular symptoms (923 records), respiratory symptoms (788 records), abdominal symptoms (478 records), other minor symptoms (460 records). Patients with shorter dialytic age and residual renal function had more nocturia than subjects with longer dialytic age and anuric (coefficient −0.22, P < 0,01). Urinary urgency and urinary frequency were symptoms significantly associated with the diagnosis of diabetes either in men and in women (coefficient 1,16, P > 0.01) and to blood hypertension in men (coefficient 1,13 P > 0.01). Sixty-one patients of the cohort (40 males, 21 females) underwent UD due to persistent urinary urgency and urinary frequency, recurrent bacterial urinary tract infections, urinary burning, bladder pain, stress urinary incontinence. UD findings were represented by detrusor overactivity, bladder outlet obstruction, detrusor underactivity, reduced bladder compliance, sphincteric striated urethral deficiency. Conclusion LUTS can be considered a prevalent condition in our population, being urinary burning associated with urinary tract infection the most represented. Nocturia resulted associated with diabetes and dialytic age. Concerning UD findings, bladder functional alterations in patients undergoing HD are often the consequence of progressive reduction of bladder filling and emptying cycle that is associated with bladder atrophy. In subjects waiting for kidney transplant, UD may contribute to prevent that functional alteration of lower urinary tract put on risk the transplanted kidney.