Urinary Symptoms in Older Adults with Chronic Kidney Disease

Urinary tract symptoms (LUTS) include urination hesitancy, poor and/or intermittent stream, straining to urinate, feeling of incomplete bladder emptying and dribbling. LUTS also include storage or irritative symptoms such as urinary frequency, urgency, incontinence and nocturia. These bothersome urinary symptoms affect a large percentage of older adults but most persons with LUTS will never discuss urinary symptoms with their physician and seek or receive treatment. For the nephrologist, LUTS may complicate treatment of kidney diseases and associated comorbidities such as hypertension and heart failure. Lack of attention to LUTS could potentially lead to suboptimal outcomes from poor compliance with medications and increased risk of hospitalizations. In this chapter, we review the definitions and epidemiology of specific urinary symptoms which encompass LUTS. The chapter also provides sample questions which may be used to query presence of LUTS and assist with diagnosis. Finally, management strategies are discussed specifically for older adults with non-dialysis dependent kidney disease.