{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T09:43:25Z","timestamp":1794563005417,"version":"4.9.1"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2013,1,7]],"date-time":"2013-01-07T00:00:00Z","timestamp":1357516800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Urinary tract infection (UTI) occurs in 30%-50% of individuals with autosomal dominant polycystic kidney disease (ADPKD). However, the clinical relevance of asymptomatic pyuria in ADPKD patients remains unknown.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We retrospectively reviewed medical records of 256 ADPKD patients who registered to the ADPKD clinic at Seoul National University Hospital from Aug 1999 to Aug 2010. We defined the asymptomatic pyuria as more than 5-9 white blood cells in high-power field with no related symptoms or signs of overt UTI. Patients were categorized into 2 groups depending on its duration and frequency: Group A included non-pyuria and transient pyuria patients; Group B included recurrent and persistent pyuria patients. The association between asymptomatic pyuria and both the development of overt UTI and the deterioration of renal function were examined.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>With a mean follow-up duration of 65.3 months, 176 (68.8%) out of 256 patients experienced 681 episodes of asymptomatic pyuria and 50 episodes of UTI. The annual incidence of asymptomatic pyuria was 0.492 episodes\/patient\/year. The patients in group B showed female predominance (58.5% vs. 42.0%, <jats:italic>P<\/jats:italic>=0.01) and experienced an upper UTI more frequently (hazard ratio: 4.612, 95% confidence interval: 1.735-12.258; <jats:italic>P<\/jats:italic>=0.002, adjusted for gender and hypertension). The annual change in estimated glomerular filtration rate (\u0394eGFR) was significantly larger in magnitude in group B than in group A (-2.7\u00b14.56 vs. -1.17\u00b15.8, respectively; <jats:italic>P<\/jats:italic>=0.01). Age and Group B found to be the independent variables for \u0394eGFR and developing end-stage renal disease (16.0% vs. 4.3%, respectively; <jats:italic>P<\/jats:italic>=0.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Chronic asymptomatic pyuria may increase the risk of developing overt UTI and may contribute to declining renal function in ADPKD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2369-14-1","type":"journal-article","created":{"date-parts":[[2013,1,7]],"date-time":"2013-01-07T11:14:30Z","timestamp":1357557270000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Chronic asymptomatic pyuria precedes overt urinary tract infection and deterioration of renal function in autosomal dominant polycystic kidney disease"],"prefix":"10.1186","volume":"14","author":[{"given":"Jin Ho","family":"Hwang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayne Cho","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Cheol","family":"Jeong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seon","family":"ha Baek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Yeun","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitae","family":"Bang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong Yeon","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suk Hee","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaeseok","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kook-Hwan","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Hwan","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curie","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,1,7]]},"reference":[{"issue":"9","key":"424_CR1","doi-asserted-by":"publisher","first-page":"2384","DOI":"10.1097\/01.ASN.0000028643.17901.42","volume":"13","author":"P Igarashi","year":"2002","unstructured":"Igarashi P, Somlo S: Genetics and pathogenesis of polycystic kidney disease. J Am Soc Nephrol. 2002, 13 (9): 2384-2398. 10.1097\/01.ASN.0000028643.17901.42.","journal-title":"J Am Soc Nephrol"},{"key":"424_CR2","volume-title":"Brenner & Rector\u2019s The Kidney","author":"FCR Brenner","year":"2000","unstructured":"Brenner FCR, Barry M: Brenner & Rector\u2019s The Kidney. 2000, Philadelphia, PA: WB Saunders Company, 6th","edition":"6th"},{"issue":"5","key":"424_CR3","doi-asserted-by":"publisher","first-page":"1654","DOI":"10.1046\/j.1523-1755.2001.0590051654.x","volume":"59","author":"GM Fick-Brosnahan","year":"2001","unstructured":"Fick-Brosnahan GM, Tran ZV, Johnson AM, Strain JD, Gabow PA: Progression of autosomal-dominant polycystic kidney disease in children. Kidney Int. 2001, 59 (5): 1654-1662. 10.1046\/j.1523-1755.2001.0590051654.x.","journal-title":"Kidney Int"},{"issue":"8","key":"424_CR4","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1007\/s00467-003-1211-4","volume":"18","author":"O Koslowe","year":"2003","unstructured":"Koslowe O, Frank R, Gauthier B, Vergara M, Trachtman H: Urinary tract infections, VUR, and autosomal dominant polycystic kidney disease. Pediatr Nephrol. 2003, 18 (8): 823-825. 10.1007\/s00467-003-1211-4.","journal-title":"Pediatr Nephrol"},{"issue":"2","key":"424_CR5","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/S0272-6386(87)80036-7","volume":"10","author":"AH Sklar","year":"1987","unstructured":"Sklar AH, Caruana RJ, Lammers JE, Strauser GD: Renal infections in autosomal dominant polycystic kidney disease. Am J Kidney Dis. 1987, 10 (2): 81-88.","journal-title":"Am J Kidney Dis"},{"issue":"4","key":"424_CR6","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1016\/0002-9343(87)90005-2","volume":"82","author":"SJ Schwab","year":"1987","unstructured":"Schwab SJ, Bander SJ, Klahr S: Renal infection in autosomal dominant polycystic kidney disease. Am J Med. 1987, 82 (4): 714-718. 10.1016\/0002-9343(87)90005-2.","journal-title":"Am J Med"},{"issue":"3","key":"424_CR7","doi-asserted-by":"publisher","first-page":"278","DOI":"10.7861\/clinmedicine.9-3-278","volume":"9","author":"CL Chow","year":"2009","unstructured":"Chow CL, Ong AC: Autosomal dominant polycystic kidney disease. Clin Med. 2009, 9 (3): 278-283.","journal-title":"Clin Med"},{"issue":"5","key":"424_CR8","doi-asserted-by":"publisher","first-page":"1311","DOI":"10.1038\/ki.1992.195","volume":"41","author":"PA Gabow","year":"1992","unstructured":"Gabow PA, Johnson AM, Kaehny WD, Kimberling WJ, Lezotte DC, Duley IT, Jones RH: Factors affecting the progression of renal disease in autosomal-dominant polycystic kidney disease. Kidney Int. 1992, 41 (5): 1311-1319. 10.1038\/ki.1992.195.","journal-title":"Kidney Int"},{"issue":"4","key":"424_CR9","first-page":"511","volume":"17","author":"ER Ahmed","year":"2006","unstructured":"Ahmed ER, Tashkandi MA, Nahrir S, Maulana A: Retrospective analysis of factors affecting the progression of chronic renal failure in adult polycystic kidney disease. Saudi J Kidney Dis Transpl. 2006, 17 (4): 511-515.","journal-title":"Saudi J Kidney Dis Transpl"},{"issue":"3","key":"424_CR10","first-page":"161","volume":"13","author":"A Idrizi","year":"2009","unstructured":"Idrizi A, Barbullushi M, Petrela E, Kodra S, Koroshi A, Thereska N: The influence of renal manifestations to the progression of autosomal dominant polycystic kidney disease. Hippokratia. 2009, 13 (3): 161-164.","journal-title":"Hippokratia"},{"issue":"1","key":"424_CR11","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1681\/ASN.2008050507","volume":"20","author":"Y Pei","year":"2009","unstructured":"Pei Y, Obaji J, Dupuis A, Paterson AD, Magistroni R, Dicks E, Parfrey P, Cramer B, Coto E, Torra R, et al: Unified criteria for ultrasonographic diagnosis of ADPKD. J Am Soc Nephrol. 2009, 20 (1): 205-212. 10.1681\/ASN.2008050507.","journal-title":"J Am Soc Nephrol"},{"issue":"5","key":"424_CR12","first-page":"933","volume":"71","author":"K Ramakrishnan","year":"2005","unstructured":"Ramakrishnan K, Scheid DC: Diagnosis and management of acute pyelonephritis in adults. Am Fam Physician. 2005, 71 (5): 933-942.","journal-title":"Am Fam Physician"},{"issue":"7","key":"424_CR13","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.2215\/CJN.01870309","volume":"4","author":"M Sallee","year":"2009","unstructured":"Sallee M, Rafat C, Zahar JR, Paulmier B, Grunfeld JP, Knebelmann B, Fakhouri F: Cyst infections in patients with autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. 2009, 4 (7): 1183-1189. 10.2215\/CJN.01870309.","journal-title":"Clin J Am Soc Nephrol"},{"issue":"3","key":"424_CR14","doi-asserted-by":"crossref","first-page":"297","DOI":"10.5858\/2005-129-297-CMSOTA","volume":"129","author":"W Greg Miller","year":"2005","unstructured":"Greg Miller W, Myers GL, Ashwood ER, Killeen AA, Wang E, Thienpont LM, Siekmann L: Creatinine Measurement: State of the Art in Accuracy and Interlaboratory Harmonization. Archives of Pathology & Laboratory Medicine. 2005, 129 (3): 297-304.","journal-title":"Archives of Pathology & Laboratory Medicine"},{"issue":"9","key":"424_CR15","doi-asserted-by":"publisher","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","volume":"150","author":"AS Levey","year":"2009","unstructured":"Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, et al: A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009, 150 (9): 604-612.","journal-title":"Ann Intern Med"},{"issue":"3","key":"424_CR16","doi-asserted-by":"publisher","first-page":"486","DOI":"10.1053\/j.ajkd.2010.03.026","volume":"56","author":"LA Stevens","year":"2010","unstructured":"Stevens LA, Schmid CH, Greene T, Zhang YL, Beck GJ, Froissart M, Hamm LL, Lewis JB, Mauer M, Navis GJ, et al: Comparative performance of the CKD Epidemiology Collaboration (CKD-EPI) and the Modification of Diet in Renal Disease (MDRD) Study equations for estimating GFR levels above 60 mL\/min\/1.73 m2. Am J Kidney Dis. 2010, 56 (3): 486-495. 10.1053\/j.ajkd.2010.03.026.","journal-title":"Am J Kidney Dis"},{"key":"424_CR17","unstructured":"K\/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002, 39 (2 Suppl 1): 1-266."},{"issue":"5662","key":"424_CR18","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1136\/bmj.3.5662.81","volume":"3","author":"SR Meadow","year":"1969","unstructured":"Meadow SR, White RH, Johnston NM: Prevalence of symptomless urinary tract disease in Birmingham schoolchildren. I. Pyuria and bacteriuria. British medical journal. 1969, 3 (5662): 81-84.","journal-title":"I. Pyuria and bacteriuria. British medical journal"},{"issue":"9","key":"424_CR19","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/j.clinbiochem.2006.06.007","volume":"39","author":"S Ozdem","year":"2006","unstructured":"Ozdem S, Bayraktar T, Oktay C, Sari R, Gultekin M: The prevalence of asymptomatic pyuria in diabetic patients: comparison of the Sysmex UF-100 automated urinalysis analyzer with Fuchs-Rosenthal hemacytometer. Clin Biochem. 2006, 39 (9): 873-878. 10.1016\/j.clinbiochem.2006.06.007.","journal-title":"Clin Biochem"},{"issue":"4","key":"424_CR20","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1038\/ng0792-235","volume":"1","author":"ST Reeders","year":"1992","unstructured":"Reeders ST: Multilocus polycystic disease. Nat Genet. 1992, 1 (4): 235-237. 10.1038\/ng0792-235.","journal-title":"Nat Genet"},{"issue":"12","key":"424_CR21","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1038\/nm1675","volume":"13","author":"K Piontek","year":"2007","unstructured":"Piontek K, Menezes LF, Garcia-Gonzalez MA, Huso DL, Germino GG: A critical developmental switch defines the kinetics of kidney cyst formation after loss of Pkd1. Nat Med. 2007, 13 (12): 1490-1495. 10.1038\/nm1675.","journal-title":"Nat Med"},{"issue":"24","key":"424_CR22","doi-asserted-by":"publisher","first-page":"3188","DOI":"10.1093\/hmg\/ddm299","volume":"16","author":"IS Lantinga-van Leeuwen","year":"2007","unstructured":"Lantinga-van Leeuwen IS, Leonhard WN, van der Wal A, Breuning MH, de Heer E, Peters DJ: Kidney-specific inactivation of the Pkd1 gene induces rapid cyst formation in developing kidneys and a slow onset of disease in adult mice. Hum Mol Genet. 2007, 16 (24): 3188-3196. 10.1093\/hmg\/ddm299.","journal-title":"Hum Mol Genet"},{"issue":"12","key":"424_CR23","doi-asserted-by":"publisher","first-page":"2351","DOI":"10.1681\/ASN.2007101139","volume":"19","author":"A Takakura","year":"2008","unstructured":"Takakura A, Contrino L, Beck AW, Zhou J: Pkd1 inactivation induced in adulthood produces focal cystic disease. J Am Soc Nephrol. 2008, 19 (12): 2351-2363. 10.1681\/ASN.2007101139.","journal-title":"J Am Soc Nephrol"},{"issue":"14","key":"424_CR24","first-page":"1477","volume":"359","author":"JJ Grantham","year":"2008","unstructured":"Grantham JJ: Clinical practice. Autosomal dominant polycystic kidney disease. N Engl J Med. 2008, 359 (14): 1477-1485.","journal-title":"Autosomal dominant polycystic kidney disease. N Engl J Med"},{"issue":"11","key":"424_CR25","doi-asserted-by":"publisher","first-page":"2389","DOI":"10.1681\/ASN.2008040435","volume":"20","author":"AP Bastos","year":"2009","unstructured":"Bastos AP, Piontek K, Silva AM, Martini D, Menezes LF, Fonseca JM, Fonseca II, Germino GG, Onuchic LF: Pkd1 haploinsufficiency increases renal damage and induces microcyst formation following ischemia\/reperfusion. J Am Soc Nephrol. 2009, 20 (11): 2389-2402. 10.1681\/ASN.2008040435.","journal-title":"J Am Soc Nephrol"},{"issue":"14","key":"424_CR26","doi-asserted-by":"publisher","first-page":"2532","DOI":"10.1093\/hmg\/ddp190","volume":"18","author":"H Happe","year":"2009","unstructured":"Happe H, Leonhard WN, van der Wal A, van de Water B, Lantinga-van Leeuwen IS, Breuning MH, de Heer E, Peters DJ: Toxic tubular injury in kidneys from Pkd1-deletion mice accelerates cystogenesis accompanied by dysregulated planar cell polarity and canonical Wnt signaling pathways. Hum Mol Genet. 2009, 18 (14): 2532-2542. 10.1093\/hmg\/ddp190.","journal-title":"Hum Mol Genet"},{"issue":"14","key":"424_CR27","doi-asserted-by":"publisher","first-page":"2523","DOI":"10.1093\/hmg\/ddp147","volume":"18","author":"A Takakura","year":"2009","unstructured":"Takakura A, Contrino L, Zhou X, Bonventre JV, Sun Y, Humphreys BD, Zhou J: Renal injury is a third hit promoting rapid development of adult polycystic kidney disease. Hum Mol Genet. 2009, 18 (14): 2523-2531. 10.1093\/hmg\/ddp147.","journal-title":"Hum Mol Genet"},{"key":"424_CR28","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1146\/annurev.med.52.1.93","volume":"52","author":"MA Arnaout","year":"2001","unstructured":"Arnaout MA: Molecular genetics and pathogenesis of autosomal dominant polycystic kidney disease. Annu Rev Med. 2001, 52: 93-123. 10.1146\/annurev.med.52.1.93.","journal-title":"Annu Rev Med"},{"issue":"5","key":"424_CR29","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1681\/ASN.2011030284","volume":"22","author":"T Weimbs","year":"2011","unstructured":"Weimbs T: Third-hit signaling in renal cyst formation. J Am Soc Nephrol. 2011, 22 (5): 793-795. 10.1681\/ASN.2011030284.","journal-title":"J Am Soc Nephrol"},{"issue":"3","key":"424_CR30","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1038\/ki.1987.213","volume":"32","author":"KD Gardner Jr","year":"1987","unstructured":"Gardner KD, Reed WP, Evan AP, Zedalis J, Hylarides MD, Leon AA: Endotoxin provocation of experimental renal cystic disease. Kidney Int. 1987, 32 (3): 329-334. 10.1038\/ki.1987.213.","journal-title":"Kidney Int"},{"issue":"12","key":"424_CR31","doi-asserted-by":"publisher","first-page":"3773","DOI":"10.1093\/ndt\/gfn533","volume":"23","author":"Y Pirson","year":"2008","unstructured":"Pirson Y: Does TNF-alpha enhance cystogenesis in ADPKD?. Nephrol Dial Transplant. 2008, 23 (12): 3773-3775. 10.1093\/ndt\/gfn533.","journal-title":"Nephrol Dial Transplant"},{"issue":"1","key":"424_CR32","doi-asserted-by":"publisher","first-page":"F261","DOI":"10.1152\/ajprenal.00263.2006","volume":"292","author":"L Wu","year":"2007","unstructured":"Wu L, Tiwari MM, Messer KJ, Holthoff JH, Gokden N, Brock RW, Mayeux PR: Peritubular capillary dysfunction and renal tubular epithelial cell stress following lipopolysaccharide administration in mice. Am J Physiol Renal Physiol. 2007, 292 (1): F261-F268.","journal-title":"Am J Physiol Renal Physiol"},{"issue":"4","key":"424_CR33","doi-asserted-by":"publisher","first-page":"698","DOI":"10.2215\/CJN.01410209","volume":"4","author":"AB Chapman","year":"2009","unstructured":"Chapman AB, Guay-Woodford LM: Renal volume in children with ADPKD: size matters. Clin J Am Soc Nephrol. 2009, 4 (4): 698-699. 10.2215\/CJN.01410209.","journal-title":"Clin J Am Soc Nephrol"},{"issue":"20","key":"424_CR34","doi-asserted-by":"publisher","first-page":"2122","DOI":"10.1056\/NEJMoa054341","volume":"354","author":"JJ Grantham","year":"2006","unstructured":"Grantham JJ, Torres VE, Chapman AB, Guay-Woodford LM, Bae KT, King BF, Wetzel LH, Baumgarten DA, Kenney PJ, Harris PC, et al: Volume progression in polycystic kidney disease. N Engl J Med. 2006, 354 (20): 2122-2130. 10.1056\/NEJMoa054341.","journal-title":"N Engl J Med"}],"container-title":["BMC Nephrology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2369-14-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2369-14-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2369-14-1","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2369-14-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T21:38:49Z","timestamp":1630532329000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnephrol.biomedcentral.com\/articles\/10.1186\/1471-2369-14-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1,7]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["424"],"URL":"https:\/\/doi.org\/10.1186\/1471-2369-14-1","relation":{},"ISSN":["1471-2369"],"issn-type":[{"value":"1471-2369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,7]]},"assertion":[{"value":"21 June 2012","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 December 2012","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2013","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"1"}}