Proteinuria and renal function during and after acute urinary retention

Purpose: Benign prostatic hyperplasia is the most common neoplasm as well a s the main cause of bladder outlet obstruction in men. It may progress to i nvolve a risk of urinary retention. We investigated the effects of acute ur inary retention on renal function. Materials and Methods: We evaluated renal function using biochemical marker s in 25 men with a mean age of 69 years in whom an episode of acute urinary retention a mean of 31 hours in duration was due to bladder outlet obstruc tion. Patients were followed for 6 months after acute retention was relieve d. Patients were not known to have had any renal disease previously. Results: During acute urinary retention at presentation, and after 1 and 6 months we noted albuminuria in 100, 92 and 54% of patients, elevated alpha 1-microglobulin excretion in 54, 39 and 58%, and elevated beta 2-microglobu lin excretion in 17, 19 and 9%. Serum creatinine or creatinine clearance di d not predict proteinuria. All parameters became normal at 6 months in only 2 cases. Conclusions: Acute urinary retention affects glomerular and tubular renal f unction. After acute urinary retention was relieved increased glomerular pe rmeability and tubular damage persisted in the majority of patients. This c ondition may have been partially due to previous long-term bladder outlet o bstruction. Our findings stress the importance of the rapid recognition and treatment of acute urinary retention.