Lorenzo-Gómez MF, Flores-Fraile MC, Márquez-Sánchez M, Flores-Fraile J, González-Casado I, Padilla-Fernández B, Valverde-Martínez S, Hernández Sánchez T, Muller-Arteaga C, García-Cenador MB. Increased urinary markers of kidney damage in the institutionalized frail elderly due to recurrent urinary tract infections.
Ther Adv Urol 2020;
12:1756287220974133. [PMID:
33335564 PMCID:
PMC7724260 DOI:
10.1177/1756287220974133]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/25/2020] [Indexed: 12/03/2022] Open
Abstract
Objective:
To characterize the impact on kidney injury of recurrent urinary tract
infections (RUTI) in the frail elderly.
Methods:
Prospective observational study in 200 frail elderly subjects for 1 year.
Groups: GA (n = 100): subjects without RUTI, GB
(n = 100): subjects with RUTI. Variables: age,
concomitant diseases, glomerular filtration rate (GFR), urine neutrophil
gelatinase-associated lipocalin (NGAL) at the beginning (NGAL-1) and end
(NGAL-2) of the study, urine N-acetyl glucosaminidase (NAG) at the beginning
(NAG-1) and the end (NAG-2) of the study, urine transforming growth
factor-beta 1 (TGFβ-1). Descriptive statistics, Mann–Whitney test,
Chi-squared test, Fisher’s exact test, and multivariate analysis were
used.
Results:
Mean age was 84.33 (65–99) years old, with no difference between GA and GB.
Mean NGAL-1 was 1.29 ng/ml (0.04–8). There was lower in GA than in GB. Mean
NGAL-2 was 1.41 ng/ml (0.02–9.22). NGAL-2 was lower in GA than in GB. Mean
NAG-1 was 0.38 UU.II/ml (0.01–2.63. NAG-1 in GA was lower than in GB. Mean
NAG-2 was 0.44 UU.II/ml (0–3.41). NAG-2 was lower in GA compared with GB.
Mean TGFβ-1 was 23.43 pg/ml (0.02–103.76). TGFβ-1 was lower in GA than GB.
There were no differences in the presence of secondary diagnoses between GA
and GB. NAG-2 and NGAL-1 were the most determining factors of renal
function; in GA it was NGAL-2, followed by NAG-1; in GB it was NGAL-1,
followed by NAG-2.
Conclusion:
Frail elderly with RUTI have higher urinary levels of renal injury markers,
specifically NGAL, NAG, and TGFβ-1, chronically in periods between urinary
tract infection (UTI). Urinary markers of renal injury, specifically NGAL,
NAG, and TGFβ-1, identify early deterioration of renal function, compared
with serum creatinine, or albuminuria, in frail elderly with recurrent
urinary infections.
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