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Chronic Kidney Disease Is a Potential Risk Factor for the Development of Purple Urine Bag Syndrome
Chih‐Jen Yang, Po‐Liang Lu, Tun‐Chieh Chen, Ying‐Ming Tasi, Chi‐Tun Lien, Inn‐Wen Chong, Ming‐Shyan Huang. Journal of the American Geriatrics Society, 2009-10-01
Topic: Brain proteins, microglia and lab models
As they mix together, they become purple.2 According to a few previous reports, PUBS often occurred in elderly women who are bedridden, chronically catheterized, and constipated.3 In addition, PUBS was found in alkaline urine and with higher bacterial counts.3,4 Because of lack of significant patient numbers, the clinical background, underlining diseases, urinanalysis, and incidence of PUBS have not been well documented. P-values <.05 were considered to be statistically significant. As shown in Table 1, there were no significant differences in their basic information, including age, living site, sex, and underlying disease, with the exception of CKD; it was found that CKD was the only significant risk factor (P=.04, odds ratio=6.00, 95% confidence interval=1.27–28.25) for PUBS. In the urinanalysis, alkaline urine (pH≥7.5) and the presence of urine phosphate crystal (amphorous, phosphate, and triple phosphate) also indicated a trend toward the development of PUBS, although this did not reach a significant level. Second, PUBS is associated with urinary tract infection. Large bacterial colonies in urinanalysis were found to be related to the development of PUBS in a case control study.3 The urinary tract maybe a significant reservoir for infection in patients undergoing hemodialysis, and pyuria was more frequent in oliguric patients with CKD;9 the condition may be related to the development of PUBS. In conclusion, we performed a hospital-based cohort study and demonstrated that CKD is a potential risk factor in the development of PUBS.
Key findings
- As they mix together, they become purple.2 According to a few previous reports, PUBS often occurred in elderly women who are bedridden, chronically catheterized, and constipated.3 In addition, PUBS was found in alkaline urine and with higher bacterial counts.3,4 Because of lack of significant patient numbers, the clinical background, underlining diseases, urinanalysis, and incidence of PUBS have not been well documented.
- P-values <.05 were considered to be statistically significant.
- As shown in Table 1, there were no significant differences in their basic information, including age, living site, sex, and underlying disease, with the exception of CKD; it was found that CKD was the only significant risk factor (P=.04, odds ratio=6.00, 95% confidence interval=1.27–28.25) for PUBS.
- In the urinanalysis, alkaline urine (pH≥7.5) and the presence of urine phosphate crystal (amphorous, phosphate, and triple phosphate) also indicated a trend toward the development of PUBS, although this did not reach a significant level.
- Second, PUBS is associated with urinary tract infection.
Why it matters
This study found that chronic kidney disease was the only significant risk factor for purple urine bag syndrome in a case-control study. It does not address treating, curing, or preventing Alzheimer's disease.
Study details
- Study designcohort study
- Effect size6.4%
- Evidence strengthModerate
How this study scored 45/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2009 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 23 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.2 citations a year over 19 year(s) since 2009 |
| Impact for its field and year | 1 / 6 | Cited 0.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Ming‐Shyan Huang: h-index 46 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Kaohsiung Medical University: institution h-index 330 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 19807795) |
| Free to read | 2 / 2 | Free to read |
| Total | 45 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1111/j.1532-5415.2009.02445.x
- PubMed: 19807795
- Original source →
- Free full text: Journal of the American Geriatrics Society →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Yang, C., Lu, P., Chen, T., Tasi, Y., Lien, C., Chong, I., et al. (2009). Chronic Kidney Disease Is a Potential Risk Factor for the Development of Purple Urine Bag Syndrome. Journal of the American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.2009.02445.x
Vancouver
Yang C, Lu P, Chen T, Tasi Y, Lien C, Chong I, et al. Chronic Kidney Disease Is a Potential Risk Factor for the Development of Purple Urine Bag Syndrome. Journal of the American Geriatrics Society. 2009. doi:10.1111/j.1532-5415.2009.02445.x. PMID: 19807795.
BibTeX
@article{yang2009-19807795,
author = {Yang, Chih‐Jen and Lu, Po‐Liang and Chen, Tun‐Chieh and Tasi, Ying‐Ming and Lien, Chi‐Tun and Chong, Inn‐Wen and Huang, Ming‐Shyan},
title = {{Chronic Kidney Disease Is a Potential Risk Factor for the Development of Purple Urine Bag Syndrome}},
journal = {Journal of the American Geriatrics Society},
year = {2009},
doi = {10.1111/j.1532-5415.2009.02445.x},
pmid = {19807795},
url = {https://doi.org/10.1111/j.1532-5415.2009.02445.x}
}