Prevalence of chronic kidney diseases in patients with chronic obstructive pulmonary disease: assessment based on glomerular filtration rate estimated from creatinine and cystatin C levels

Abstract

BackgroundCardiovascular diseases, osteoporosis, and depression are identified comorbidities of chronic obstructive pulmonary disease (COPD), but there have been few reports of chronic kidney disease (CKD) as a comorbidity of COPD. The objective of this study was to investigate the prevalence of CKD in COPD patients using estimated glomerular filtration rate (eGFR) based on creatinine (Cr) and cystatin C (Cys) levels.MethodsThe prevalence of CKD and the values of various CKD-related parameters were compared between 108 stable COPD outpatients (COPD group) and a non-COPD control group consisting of 73 patients aged 60 years or more without a history of COPD or kidney disease. CKD was defined as an eGFR less than 60 mL/min/1.73 m2.ResultsThe Cr level was significantly higher in the COPD group, but eGFR based on serum Cr (eGFRCr) was not significantly different between the two groups (73.3±25.3 vs 79.7±15.5 mL/min/1.73 m2). The Cys level was significantly higher and eGFR based on serum Cys (eGFRCys) was significantly lower in the COPD group (60.0±19.4 vs 74.0±13.5 mL/min/1.73 m2, P<0.0001). The prevalence of CKD evaluated based on eGFRCr was 31% in the COPD group and 8% in the non-COPD group with an odds ratio of 4.91 (95% confidence interval, 1.94–12.46, P=0.0008), whereas the evaluated prevalence based on eGFRCys was 53% in the COPD group and 15% in the non-COPD group with an odds ratio of 6.30 (95% confidence interval, 2.99–13.26, P<0.0001), demonstrating a higher prevalence of CKD when based on eGFRCys rather than on eGFRCr.ConclusionCKD is a comorbidity that occurs frequently in COPD patients, and we believe that renal function in Japanese COPD patients should preferably be evaluated based not only on Cr but on Cr in combination with Cys.

Prevalence of chronic kidney disease in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis

“…After detailed review of the articles, our literature search resulted in 17 studies related to the topic of our research. Manual search for related articles helped identify an additional study that was recently published and did not have a PubMed ID [17]. Another study was published in April 2016 while we were in the process of submission for publication [18].…”

“…Nine of these studies reported the prevalence of CKD in patients with COPD compared to those without COPD [17–26]. We reported a detailed review of these studies with data extraction in Table 1 and we included the results reported in these studies in a meta-analysis to estimate the cumulative effect.…”

Is Renal Impairment an Anticipated COPD Comorbidity?

“…2 Indeed, patients with COPD exhibit reduced muscle mass 12 ; thus, the serum creatinine levels might be falsely low as the result of decreased creatine release. 6 This decrease was verified by Yoshizawa et al, 20 who found that the estimated glomerular filtration rate did not differ between the COPD and non-COPD groups when an estimation formula based on serum creatinine was used, but the COPD group exhibited significantly reduced estimated glomerular filtration rate when a formula based on serum cystatin C was employed.…”

Contribution of chronic obstructive pulmonary disease to remodeling of target organs in patients with arterial hypertension and ischemic heart disease associated with chronic heart failure

“…Так, по данным T. Yoshizawa и соавт., при обследовании 108 больных со стабильной ХОБЛ и 79 пациентов без бронхолегоч ных заболеваний было найдено, что уровень креати нина в сыворотке крови был достоверно выше у боль ных с бронхиальной обструкцией, но соотношение СКФ к уровню сывороточного креатинина достоверно между группами не различалось [13]. Более чувстви тельным маркером нарушения фильтрационной функ ции почек при ХОБЛ стал показатель концентрации цистатина С в крови, который был достоверно выше при бронхиальной обструкции, чем при нормальной функции бронхов, а также соотношение СКФ к уровню концентрации цистатина С в сыворотке крови, значе ние которого было значительно ниже в группе боль ных ХОБЛ.…”