The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men.
BACKGROUND
Benign prostatic hyperplasia (BPH) and chronic kidney disease are important public health problems in older men. Previous referral-based studies disagree on whether BPH is associated with chronic kidney disease. The objective of this study was to determine the community-based association between clinical measures of BPH and chronic kidney disease.


METHODS
A community-based sample of 2115 white men (ages 40-79 years) was randomly selected from the Olmsted County, Minnesota population (55% participation rate) in 1990. A random subsample (N= 476) had a detailed clinical evaluation. This evaluation included a questionnaire with similar queries to the International Prostate Symptom Score (IPSS), peak urinary flow rates (uroflowmeter), postvoid residual urine volume (ultrasound), prostate volume (ultrasound), serum prostate specific antigen (PSA), and serum creatinine.


RESULTS
After adjustment for age, hypertension, diabetes, leukocyte esterase positive (possible urinary tract infection), and smoking, chronic kidney disease [serum creatinine > or =133 micromol/L (1.5 mg/dL)] was associated with diminished peak urinary flow rate (<15 mL/sec) by an odds ratio (OR) = 2.96 (95% CI 1.30-7.01), moderate-severe lower urinary tract symptoms (IPSS >7) by an OR = 2.91 (95% CI 1.32-6.62), and chronic urinary retention (postvoid residual >100 mL) by an OR = 2.28 (95% CI 0.66-6.68). There was no association with a prostate volume >30 mL by an OR = 0.56 (95% CI 0.22-1.37) or PSA >1.4 ng/mL by an OR = 1.17 (95% CI 0.47-2.81).


CONCLUSIONS
There was a cross-sectional association between signs and symptoms of bladder outlet obstruction and chronic kidney disease in community-dwelling men. Prostatic enlargement was not associated with chronic kidney disease.
Rule
Andrew D
AD
Division of Nephrology, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Jacobson
Debra J
DJ
Roberts
Rosebud O
RO
Girman
Cynthia J
CJ
McGree
Michaela E
ME
Lieber
Michael M
MM
Jacobsen
Steven J
SJ
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011470:Prostatic Hyperplasia / Q000150:complications*; D012307:Risk Factors; D001748:Urinary Bladder Neck Obstruction / Q000150:complications