Prevalence and correlates of elevated serum creatinine levels - The Framingham heart study

Background: Elevated serum creatinine (SCr) levels are a predictor of end-s tage renal disease, but little is known about the prevalence of elevated SC r levels and their correlates in the community. Methods: In this cross-sectional, community-based sample, SCr levels were m easured in 6233 adults (mean age, 54 years; 54% women) who composed the "br oad sample" of this investigation. A subset, consisting of 3241 individuals who were free of known renal disease, cardiovascular disease, hypertension , and diabetes, constituted the healthy reference sample. In this latter sa mple, sex-specific 95th percentiles for SCr levels (men, 136 mu mol/L [1.5 mg/dL]; women, 120 mu mol/L [1.4 mg/dL]) were labeled cutpoints. These cutp oints were applied to the broad sample in a logistic regression model to id entify prevalence and correlates of elevated SCr levels. Results: The prevalence of elevated SCr levels was 8.9% in men and 8.0% in women. Logistic regression in men identified age, treatment for hypertensio n (odds ratio [OR], 1.75; 95% confidence interval [CI], 1.27-2.42), and bod y mass index (OR, 1.08; 95% CI, 1.01-1.15) as correlates of elevated SCr le vels. Additionally, men with diabetes who were receiving antihypertensive m edication were more likely to have raised SCr values (OR, 2.94, 95% CI, 1.6 0-5.39). In women, age, use of cardiac medications (OR, 1.58; 95% CI, 1.10- 2.96), and treatment for hypertension (OR, 1.42; 95% CI, 1.07-1.87) were as sociated with elevated SCr levels. Conclusions: Elevated SCr levels are common in the community and are strong ly associated with older age, treatment for hypertension, and diabetes. Lon gitudinal studies are warranted to determine the clinical outcomes of indiv iduals with elevated levels of SCr and to examine factors related to the pr ogression of renal disease in the community.