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Observational Study
. 2021 Aug 16;13(8):2811.
doi: 10.3390/nu13082811.

Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study

Corrado Pelaia  1 , Daniele Pastori  2 , Giuseppe Armentaro  1 , Sofia Miceli  1 , Velia Cassano  1 , Keti Barbara  1 , Giulia Pelaia  1 , Maria Perticone  1 , Raffaele Maio  1 , Pasquale Pignatelli  2 , Francesco Violi  2 , Francesco Perticone  1 , Giorgio Sesti  3 , Angela Sciacqua  1
Affiliations
Observational Study

Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study

Corrado Pelaia et al. Nutrients. .

Abstract

Background: Chronic obstructive pulmonary disease (COPD) patients have multiple comorbidities which may affect renal function. Chronic kidney disease (CKD) is a risk factor for adverse outcomes in COPD patients. The predictors of CKD in COPD are not well investigated.

Methods: A multicenter observational cohort study including patients affected by COPD (GOLD stages 1 and 2) was carried out. Principal endpoints were the incidence of CKD, as defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and the rapid decline of eGFR >5 mL/min/1.73 m2/year.

Results: We enrolled 707 outpatients. Overall, 157 (22.2%) patients had CKD at baseline. Patients with CKD were older, with higher serum uric acid (UA) levels, and lower FEV1. During a mean follow-up of 52.3 ± 30.2 months, 100 patients developed CKD, and 200 patients showed a rapid reduction of eGFR. Multivariable Cox regression analysis displayed that UA (hazard ratio (HR) 1.148, p < 0.0001) and diabetes (HR 1.050, p < 0.0001) were predictors of incident CKD. The independent predictors of rapidly declining renal function were represented by an increase of 1 mg/dL in UA (odds ratio (OR) 2.158, p < 0.0001)), an increase of 10 mL/min/1.73 m2 in baseline eGFR (OR 1.054, p < 0.0001) and the presence of diabetes (OR 1.100, p < 0.009).

Conclusions: This study shows that COPD patients have a significant worsening of renal function over time and that UA and diabetes were the two strongest predictors. Optimal management of these risk factors may reduce the incidence of CKD in this population thus probably improving clinical outcome.

Keywords: COPD; diabetes; oxidative stress; renal failure; uric acid.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of eGFR classes in the entire cohort of chronic obstructive pulmonary disease patients at baseline and during follow-up. Abbreviations: eGFR, estimated glomerular filtration rate.
Figure 2
Figure 2
Schematic illustration of study findings. Abbreviations: COPD, chronic obstructive pulmonary disease; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HR, hazard ratio.
See this image and copyright information in PMC

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