Clinical Nephrology – Epidemiology – Clinical Trials
Kidney International (2005) 67, 2376–2382; doi:10.1111/j.1523-1755.2005.00344.x
The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men
ANDREW D RULE, DEBRA J JACOBSON, ROSEBUD O ROBERTS, CYNTHIA J GIRMAN, MICHAELA E MCGREE, MICHAEL M LIEBER and STEVEN J JACOBSEN
Division of Nephrology, Department of Internal Medicine; Division of Epidemiology, Department of Health Science Research; Division of Biostatistics; Department of Urology, Mayo Clinic College of Medicine, Rochester, Minnesota; and Merck Research Laboratories, Blue Bell, Pennsylvania
Correspondence: Dr Steven J. Jacobsen, Department of Health Sciences Research, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905. E-mail:jacobsen@mayo.edu
Received 22 September 2004; Revised 30 November 2004; Accepted 20 January 2005.
Abstract
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 
133 
mol/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).
Conclusion
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.
Keywords:
bladder neck obstruction, chronic kidney failure, creatinine, prostatic hyperplasia
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