Currently Viewing:
Newsroom
Currently Reading
Insomnia Correlated to an Increased Risk of Heart Disease and Stroke, Study Shows
August 19, 2019 – Matthew Gavidia
Inspiratory Muscle Training May Be an Option for Patients Who Decline Pulmonary Rehabilitation for COPD
August 18, 2019 – Kelly Davio
Blood Clots in MPN Related to Higher Cost, Length of Stay for Patients With MPN
August 17, 2019 – AJMC Staff
Researchers Seek to Determine Genetic Variability in Parkinson Progression
August 17, 2019 – AJMC Staff
FDA Panel Backs Use of Descovy for HIV Prevention in Men, Transgender Women
August 16, 2019 – Jaime Rosenberg
Researcher Excited About Future of Psoriasis Treatment
August 16, 2019 – Allison Inserro
This Week in Managed Care: August 16, 2019
August 16, 2019
AJMC® in the Press, August 16, 2019
August 16, 2019 – AJMC Staff
Pediatric Leukemia Treatment Linked to Increased Risk of Infections, Study Finds
August 16, 2019 – Alison Rodriguez

Chronic Kidney Disease in COPD Negatively Impacts Mortality, Other Patient Outcomes

Jaime Rosenberg
Chronic kidney disease comorbid with chronic obstructive pulmonary disease (COPD) was associated with increased mortality, independent of other cardiovascular comorbidities.
Chronic kidney disease (CKD) is a common comorbidity among patients with chronic obstructive pulmonary disease (COPD) that can influence mortality and other patient outcomes, according to findings from an analysis assessing the relationship between the 2 conditions.

The analysis of nearly 2300 patients with COPD enrolled in the German COSYCONET cohort study included 161 patients who also had CKD. Patients with both conditions had mortality rates that were over 2 times those seen among patients with COPD alone.

Patients with comorbid CKD more frequently reported having other comorbidities, including cardiovascular and cerebrovascular disease, peripheral artery disease, diabetes, gout, and malignancies. These patients were at an increased risk of mortality independent of other cardiovascular comorbidities.

The analysis also revealed that functional status and exercise capacity were compromised among patients with comorbid CKD, with these patients taking significantly longer to complete the Timed Up and Go Test, which assesses a person’s mobility, and walking a significantly shorter distance during a 6-minute walk test.

“Our study suggests that these negative outcomes might be mediated by an impact of CKD on symptoms, functional status and exercise capacity,” wrote the researchers. “The effects of CKD on exercise capacity cannot simply be explained by the higher frequency of these comorbidities, but suggest that CKD per se has a negative effect on exercise capacity.”

They added that the underlying mechanisms of this finding are likely complex and include increased systemic inflammation, physiological interaction between lungs and kidneys, or network effects between various comorbidities and cardiovascular diseases. CKD impacts other manifestations of COPD, including malnutrition, osteoporosis, and cardiovascular disease, which negatively affect exercise capacity and could explain these results, explained the researchers.

Using the modified British Medical Research Council dyspnea scale, the researchers showed that CKD exacerbated dyspnea in patients with COPD, which also reduced exercise capacity as measured by the 6-minute walk test. The estimated glomerular filtration rate spline interpolations showed that as kidney impairment increased, the impact on dyspnea, exercise capacity, and health status also increased.

“We therefore speculate that a higher proportion of CKD category 4 and 5 patients would have led to more pronounced differences between the two categories,” wrote the researchers.”

Laboratory testing revealed that hemoglobin was significantly lower in patients with COPD and CKD compared with patients with COPD alone, and patients with CKD had significantly elevated blood glucose and glycated hemoglobin. However, there were no differences in terms of leukocytes, C-reactive protein, or cholesterol between the 2 groups.

Reference

Trudzinski F, Alqudrah M, Omlar A, et al. Consequences of chronic kidney disease in chronic obstructive pulmonary disease [published online July 12, 2019]. Respir Res. doi: 10.1186/s12931-019-1107-x.

 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up