Association of Lower Urinary Tract Symptom Severity with Kidney Function Among Community-Dwelling Older Men.
Most international practice guidelines recommend screening for chronic kidney disease among older men with lower urinary tract symptoms. However, prior studies supporting these guidelines are insufficient due to incomplete assessments of kidney function and inadequate adjustment for confounding factors.We conducted a cross-sectional study among 5,530 American men over age 65 years in the multicenter Osteoporotic Fractures in Men Study. Chronic kidney disease was defined per international guidelines as estimated glomerular filtration rate <60 mL/min based on serum creatinine or cystatin c or urinary albumin:creatinine ratio ≥30 mg/g. Lower urinary tract symptoms were assessed with the American Urologic Association Symptom Index. Associations were estimated using multivariable linear and modified Poisson regression models.Chronic kidney disease prevalence was 16% among 5530 men with serum creatinine, 24% among 1,504 men with serum cystatin c, and 14% among 1,487 men with urinary albumin:creatinine measurements. Lower urinary tract symptoms were not associated with lower estimated glomerular filtration rate based on serum creatinine or cystatin c. Although symptom severity was modestly associated with a higher prevalence of chronic kidney disease in age/site-adjusted analyses, confidence intervals were wide and associations using all 3 definitions were not statistically significant after adjustment for important confounders, including cardiovascular disease and analgesic use.Lower urinary tract symptoms are not independently associated with multiple measures of kidney dysfunction or prevalence of chronic kidney disease among older community-dwelling men. Our results do not support recommendations for kidney function testing among older men with lower urinary tract symptoms.