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 ³1.3 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%) 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% (76/1494). The prevalence of hypercreatinemia increased significantly with age (c 2 = 26.17, P = 0.000), being higher for older men (8.19%) than for older women (5.29%, c 2 = 5.00, P = 0.02). Elevated SCr levels were associated with age 70-79 years (odds ratio [OR] = 2.25, 95% confidence interval [CI]: 1.15-4.42), hypertension (OR = 3.04, 95% CI: 1.34-6.92), use of antihypertensive drugs (OR = 2.46, 95% CI: 1.26-4.82), chest pain (OR = 3.37, 95% CI: 1.31-8.74), and claudication (OR = 3.43, 95% CI: 1.30-9.09) among men, and with age >80 years (OR = 4.88, 95% CI: 2.24-10.65), use of antihypertensive drugs (OR = 4.06, 95% CI: 1.67-9.86), physical inactivity (OR = 2.11, 95% CI: 1.11-4.02) and myocardial infarction (OR = 3.89, 95% 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.

Prevalência de doença renal crônica em adultos no Brasil: revisão sistemática da literatura

“…Destes, selecionamos 34 para leitura em texto completo, sendo excluídos 18 pelos motivos constantes na Figura 1. Finalmente incluímos 16 estudos [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] . Apenas a publicação principal de cada pesquisa é citada para fins de clareza do texto.…”

“…Também foi comum como a mensuração inadequada dos desfechos, utilizando o autorrelato dos pacientes 24,29,32,38 ou por dosagens laboratoriais em episódio único 23,26,28,31,33,34,36,37 . Não houve cálculo prévio do tamanho da amostra em cinco pesquisas 25,27,28,30,31 .…”

“…A coorte de idosos de Bambuí (N=2.312) realizou uma etapa transversal com a inclusão de adultos maiores de 18 anos: 3,46% apresentaram creatinina sérica elevada, sendo maior nos idosos do sexo masculino 23 . O inquérito populacional realizado em 1.439 adultos de Salvador no ano 2000 encontrou 3,13% de hipercreatininemia, com maior prevalência no sexo masculino 26 .…”

“…Pesquisas que usaram os melhores critérios diagnósticos partiram de amostras selecionadas, sem representatividade da população: estudos de melhor validade interna para o diagnóstico tiveram baixa capacidade de generalização. Como resultado dessa baixa validade externa, tiveram as maiores prevalências 23,30,34,36,37 .…”

Investigation of urinary abnormalities and risk factors for kidney disease in the World Kidney Day campaigns in Northeast Brazil

“…In a previous study conducted in the State of Minas Gerais, the prevalence of elevated creatinine was higher in the elderly. 3 In another study investigating the prevalence of CKD (stages 3, 4 and 5) in adults was 9.6%. 4 End-stage renal disease (ESRD) has reached epidemic proportion with more than 400,000 affected individuals in the United States and over one million worldwide.…”