To determine the usefulness of routine serum creatinine measurements in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) and to correlate these findings with patient age, symptom severity, and comorbid diseases.

We analyzed serum creatinine measurements in 246 consecutive men presenting for evaluation of voiding symptoms and BPH. Multiple logistic regression analysis was used to determine whether the International Prostate Symptom Score (IPSS), quality-of-life measure from the IPSS, patient age, or a history of diabetes mellitus or hypertension predicted abnormal creatinine levels.

An elevated serum creatinine level was noted in 11% (26 of 245) of evaluable patients. Only a history of diabetes or hypertension predicted the presence of renal insufficiency. Among men with no history of comorbid disease, increasing age was significantly associated with the finding of an abnormal creatinine. Neither the overall symptom score nor the quality-of-life measure was significantly associated with the likelihood of detectable renal dysfunction.

Medical renal disease secondary to diabetes or hypertension appears to be the most likely cause of elevated serum creatinine measurements in men with BPH and renal insufficiency. We were unable to identify subgroups of patients in whom the risk of renal dysfunction is sufficiently low to avoid routine serum creatinine measurements.