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INTRODUCTION: This 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. METHODS: An 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. RESULTS: Renal 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. CONCLUSION: The 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.
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INTRODUCTION: For benign prostatic hyperplasia, clinical trials help assess new medical and surgical treatment options. The U.S. National Library of Medicine maintains ClinicalTrials.gov to provide access to prospective trials on diseases. This study investigates registered benign prostatic hyperplasia trials to determine if there are widespread differences in outcome measures and study criteria. METHODS: Interventional research with known study status on ClinicalTrials.gov identified by the keywords "benign prostatic hyperplasia" was examined. Inclusion/exclusion criteria, primary outcomes, secondary outcomes, study status, study enrollment, country of origin, and intervention category were studied. RESULTS: Of the 411 studies identified, International Prostate Symptom Score was the most common study outcome and was the primary or secondary study outcome in 65% of trials. Maximum urinary flow was the second most common study outcome (40.1% of studies). No other outcomes were measured as the primary or secondary outcome for more than 30% of studies. The most common inclusion criteria were a minimum International Prostate Symptom Score (48.9%), maximum urinary flow (34.8%), and minimum prostate volume (25.8%). Among studies using a minimum International Prostate Symptom Score, 13 was the most common minimum (35.3%) and a range of 7-21 was noted. The most common maximum urinary flow for inclusion was 15 mL/s (78 trials). CONCLUSIONS: Among clinicals trials on benign prostatic hyperplasia registered on ClinicalTrials.gov, a majority of studies utilized International Prostate Symptom Score as a primary or secondary outcome. Unfortunately, there were major differences in the inclusion criteria; these dissimilarities between trials may limit comparability of results across trials.