The Two Phenotypes of Renal Failure Associated with Chronic Urinary Retention
- 1Department of Urology, Hadassah Hebrew University Hospital, P.O. Box 12000, Jerusalem 91120, Israel
Abstract
Background: Renal failure (RF) is a severe complication of chronic urinary retention (CUR). In this study, we inquired whether RF associated with CUR is a single entity or comprises two different phenotypes: one with rapid onset and recovery after bladder catheterization and the other with gradual onset and limited reversibility. We also assessed whether these two phenotypes could be distinguished at presentation. Methods: This retrospective study included 161 men hospitalized from 2000 through 2025 with CUR and RF, defined as serum creatinine ≥2.0 mg/dL. Results: After catheterization, serum creatinine decreased to <2.0 mg/dL in 121 patients (75.2%; phenotype one) and remained ≥2.0 mg/dL in 40 (24.8%; phenotype two). The groups did not differ in age, bladder volume at catheterization or in prostate volumes. Among 49 patients with phenotype one who had a creatinine measurement during the preceding year, 48 had a normal value, supporting rapid development of RF. Mean admission hemoglobin was 12.7 g/dL (SD 1.9) in phenotype one and 9.8 g/dL (SD 1.9) in phenotype two (<0.0001). A hemoglobin cutoff of 11.7 g/dL predicted phenotype one with 73.6% sensitivity and 90.0% specificity; the area under the receiver operating characteristic curve was 0.888. Conclusions: We concluded that CUR-associated RF appears to comprise a rapidly reversible phenotype and a slowly developing, minimally reversible one. Admission hemoglobin may help distinguish these groups. We suggest that RF arises through two different pathophysiological mechanisms in the two types.
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BibTeX
@article{gofrit2026phenotypes,
title = {{The Two Phenotypes of Renal Failure Associated with Chronic Urinary Retention}},
author = {Ofer N. Gofrit and Vladimir Yutkin and Guy Hidas and Mohammad Zuaiter and Mordechai Duvdevani and Amitay Lorber},
journal = {Journal of Clinical Medicine},
year = {2026},
month = nov,
doi = {10.3390/jcm15218680},
url = {https://www.mdpi.com/2077-0383/15/21/8680},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The Two Phenotypes of Renal Failure Associated with Chronic Urinary Retention
AU - Ofer N. Gofrit
AU - Vladimir Yutkin
AU - Guy Hidas
AU - Mohammad Zuaiter
AU - Mordechai Duvdevani
AU - Amitay Lorber
PY - 2026
DA - 2026/11/06
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15218680
UR - https://www.mdpi.com/2077-0383/15/21/8680
AB - Background: Renal failure (RF) is a severe complication of chronic urinary retention (CUR). In this study, we inquired whether RF associated with CUR is a single entity or comprises two different phenotypes: one with rapid onset and recovery after bladder catheterization and the other with gradual onset and limited reversibility. We also assessed whether these two phenotypes could be distinguished at presentation. Methods: This retrospective study included 161 men hospitalized from 2000 through 2025 with CUR and RF, defined as serum creatinine ≥2.0 mg/dL. Results: After catheterization, serum creatinine decreased to <2.0 mg/dL in 121 patients (75.2%; phenotype one) and remained ≥2.0 mg/dL in 40 (24.8%; phenotype two). The groups did not differ in age, bladder volume at catheterization or in prostate volumes. Among 49 patients with phenotype one who had a creatinine measurement during the preceding year, 48 had a normal value, supporting rapid development of RF. Mean admission hemoglobin was 12.7 g/dL (SD 1.9) in phenotype one and 9.8 g/dL (SD 1.9) in phenotype two (<0.0001). A hemoglobin cutoff of 11.7 g/dL predicted phenotype one with 73.6% sensitivity and 90.0% specificity; the area under the receiver operating characteristic curve was 0.888. Conclusions: We concluded that CUR-associated RF appears to comprise a rapidly reversible phenotype and a slowly developing, minimally reversible one. Admission hemoglobin may help distinguish these groups. We suggest that RF arises through two different pathophysiological mechanisms in the two types.
SN - 2077-0383
ER -