Objective:To summarize the relevant evidence for the prevention of contrast-associated acute kidney injury (CA-AKI) after enhanced CT examination in patients with nephropathy.Methods:The literature on prevention of CA-AKI in patients with nephropathy who underwent enhanced CT examination in relevant websites and medical literature databases at home and abroad were systematically searched, the quality of the literature was evaluated, and the relevant evidence was extracted and summarized. The retrieval period was from January 1, 2013 to December 1, 2023.Results:A total of 17 literature was included, including 6 guidelines, 5 expert consensuses, 2 clinical decisions, 2 cohort studies, 1 evidence summary and 1 systematic review. Evidence was extracted from these literature. After summary and analysis of these evidence, 10 evidence topics were sorted out, including threshold of estimated glomerular filtration rate and high-risk population, screening, hydration prevention, drug prevention, use of nephrotoxic drugs, use of metformin, precautions for dialysis patients, alternative imaging strategies, choice of iodine contrast agents, and points for attention after enhanced CT examination, forming 47 pieces of evidence.Conclusion:The relevant evidence for the prevention of CA-AKI can provide a more systematic evidence-based basis for medical staffs in screening high-risk population and preventing and managing CA-AKI in patients with chronic kidney disease before enhanced CT examination.

Objective:To summarize the relevant evidence for the prevention of contrast-associated acute kidney injury (CA-AKI) after enhanced CT examination in patients with nephropathy.Methods:The literature on prevention of CA-AKI in patients with nephropathy who underwent enhanced CT examination in relevant websites and medical literature databases at home and abroad were systematically searched, the quality of the literature was evaluated, and the relevant evidence was extracted and summarized. The retrieval period was from January 1, 2013 to December 1, 2023.Results:A total of 17 literature was included, including 6 guidelines, 5 expert consensuses, 2 clinical decisions, 2 cohort studies, 1 evidence summary and 1 systematic review. Evidence was extracted from these literature. After summary and analysis of these evidence, 10 evidence topics were sorted out, including threshold of estimated glomerular filtration rate and high-risk population, screening, hydration prevention, drug prevention, use of nephrotoxic drugs, use of metformin, precautions for dialysis patients, alternative imaging strategies, choice of iodine contrast agents, and points for attention after enhanced CT examination, forming 47 pieces of evidence.Conclusion:The relevant evidence for the prevention of CA-AKI can provide a more systematic evidence-based basis for medical staffs in screening high-risk population and preventing and managing CA-AKI in patients with chronic kidney disease before enhanced CT examination.

Objective:To discover the clinical features of nocturnal enuresis (NE) in adults and to detect factors that correlated with the symptom severity.Methods:This cross-sectional study recruited NE subjects from September 2017 through December 2020. All patients had experienced enuresis at least once per week and with a symptom duration of 3 months or longer. Followed by documentation of history and medical records, three-day bladder diary was adopted to assess their voiding pattern, and urodynamic parameters were obtained to evaluate lower urinary tract function.Results:A total of 106 NE patients (43 male and 63 female) were identified. There is no statistical difference regarding the average age (men: 57.8±15.6 vs. women: 56.1±14.0, P>0.05) and BMI (men: 23.9±3.4 vs. women: 23.3±4.3, P>0.05) between men and women. Comorbidities are extremely common in NE patients (n=85, 80.2%), with the incidence rate higher in men compared to women [88.4% (38/43)vs. 74.6% (47/63), P<0.05]. Hypertension (n=58, 54.7%), hyperlipemia (n=41, 38.7%), diabetes mellitus (n=38, 35.8%), coronary heart disease (n=22, 20.8%) were the most frequently reported conditions. On bladder diaries, subjects were frequently manifested nocturnal polyuria (NP, 47/106, 44.3%), reduced nocturnal bladder capacity (NBC, 74/106, 69.8%), or combination of both(33/106, 31.3%). Urodynamic studies suggested that the incidence of reduce bladder compliance, detrusor overactivity (DO), stress incontinence, bladder outlet obstruction(BOO), detrusor underactivity(DU)and detrusor hyperreflexia with impaired contractility(DHIC)was 27.4%(29/106), 39.6%(42/106), 17.9%(19/106), 9.4%(10/106), 25.5%(27/106)and 15.1%(16/106), respectively. Women were more likely to suffer from stress urinary incontinence [2.3%(1/43) men vs. 28.6% (18/63) women, P<0.01], while men were prone to have bladder outlet obstruction [ 23.3%(10/43) men vs. 0 women, P<0.01]. Correlation analysis demonstrated that obesity( r=0.63, P<0.01), systemic comorbidities( r=0.40, P<0.01), presence of NP( r=0.50, P<0.01) and NP+ NBC( r=0.47, P<0.01), post-void residual( r=0.53, P<0.01), reduced compliance( r=0.21, P=0.04), DU( r=0.28, P<0.01), stress incontinence( r=0.42, P<0.01)and DHIC ( r=0.35, P<0.01)are positively correlated with NE severity. Whereas, reduced Q max( r=-0.35, P<0.01), low capacity( r=0.21, P=0.03), and reduced bladder sensation( r=-0.21, P=0.03) correlate negatively with NE severity. Conclusions:The presence of NE is not only a sign of bladder dysfunction, but also an implication of obesity, systematic chronic diseases, urine production malfunctioning. Therefore, a thorough history regarding the lower urinary tract function and systemic comorbidities should be taken carefully, so that, an integrated and personalized treatment can be carried out.