Detection of renal dysfunction based on serum creatinine levels in a Brazilian community: the Bambuí Health and Ageing Study

ABSTRACT

There are few population-based studies of renal dysfunction and none conducted in developing countries. In the present study the prevalence and predictors of elevated serum creatinine levels (SCr > or = 1.3 mg/dl for men and 1.1 mg/dl for women) were determined among Brazilian adults (18-59 years) and older adults (>60 years). Participants included all older adults (N = 1742) and a probabilistic sample of adults (N = 818) from Bambuí town, MG, Southeast Brazil. Predictors were investigated using multiple logistic regression. Mean SCr levels were 0.77 ± 0.15 mg/dl for adults, 1.02 ± 0.39 mg/dl for older men, and 0.81 ± 0.17 mg/dl for older women. Because there were only 4 cases (0.48 percent) with elevated SCr levels among adults, the analysis of elevated SCr levels was restricted to older adults. The overall prevalence of elevated SCr levels among the elderly was 5.09 percent (76/1494). The prevalence of hypercreatinemia increased significantly with age (chi² = 26.17, P = 0.000), being higher for older men (8.19 percent) than for older women (5.29 percent, chi² = 5.00, P = 0.02). Elevated SCr levels were associated with age 70-79 years (odds ratio [OR] = 2.25, 95 percent confidence interval [CI] 1.15-4.42), hypertension (OR = 3.04, 95 percent CI 1.34-6.92), use of antihypertensive drugs (OR = 2.46, 95 percent CI 1.26-4.82), chest pain (OR = 3.37, 95 percent CI 1.31-8.74), and claudication (OR = 3.43, 95 percent CI 1.30-9.09) among men, and with age >80 years (OR = 4.88, 95 percent CI 2.24-10.65), use of antihypertensive drugs (OR = 4.06, 95 percent CI 1.67-9.86), physical inactivity (OR = 2.11, 95 percent CI 1.11-4.02) and myocardial infarction (OR = 3.89, 95 percent CI 1.58-9.62) among women. The prevalence of renal dysfunction observed was much lower than that reported in other population-based studies, but predictors were similar. New investigations are needed to confirm the variability in prevalence and associated factors of renal dysfunction among populations