The role of renal circadian biorhythms in lifelong LUTS

Abstract

IntroductionThis article delves into the intricate relationship between kidney function, diuresis, and lower urinary tract symptoms (LUTS) throughout the transitions of the human lifespan. It explores circadian regulation of urine production, maturation of renal function from birth to adulthood, and effects of aging on kidney function and LUTS. The complex connections between these factors are highlighted, offering insights into potential interventions and personalized management strategies.MethodsAn international panel of seven experts engaged in online discussions, focusing on kidney function, diuresis, and LUTS throughout life. This manuscript summarizes expert insights, literature reviews, and findings presented during a webinar and subsequent discussions.ResultsRenal function undergoes significant maturation from birth to adulthood, with changes in glomerular filtration rate, diuresis, and tubular function. A circadian rhythm in urine production is established during childhood. Adolescents and young adults can experience persistent enuresis due to lifestyle factors, comorbidities, and complex physiological changes. In older adults, age‐related alterations in kidney function disrupt the circadian rhythm of diuresis, contributing to nocturnal polyuria and LUTS.ConclusionThe interplay between kidney function, diuresis, and LUTS is crucial in understanding lifelong urinary health. Bridging the gap between pediatric and adult care is essential to address enuresis in adolescents and young adults effectively. For older adults, recognizing the impact of aging on renal function and fluid balance is vital in managing nocturia. This holistic approach provides a foundation for developing innovative interventions and personalized treatments to enhance quality of life for individuals with LUTS across all stages of life.

The cost of lifelong LUTS—A systematic literature review

“…2 Furthermore, the link between kidney function, diuresis, and LUTS is indispensable to the bigger picture of LUTS. 3 Pediatric and adult care needs to be tackled in a multidisciplinary way to address enuresis in adolescents and young adults. A holistic approach is demanded to develop innovative interventions and personalized treatments for patients with LUTS in all stages of life.…”

“…A holistic approach is demanded to develop innovative interventions and personalized treatments for patients with LUTS in all stages of life. 3 The overall rising cost of health care systems means that it is important to control unnecessary spending, especially for patients with relapsing or chronic diseases. Understanding the cost of illness of different diseases can help us allocate resources and research activities.…”

“…The concept of “lifelong LUTS” has evolved because LUTS is influenced by various genetic factors, molecular changes, and other factors such as pelvic force 2 . Furthermore, the link between kidney function, diuresis, and LUTS is indispensable to the bigger picture of LUTS 3 . Pediatric and adult care needs to be tackled in a multidisciplinary way to address enuresis in adolescents and young adults.…”