Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study
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 observat...
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doaj-3c3b847b0fab4fbbbc3b558c276631d52021-08-26T14:11:02ZengMDPI AGNutrients2072-66432021-08-01132811281110.3390/nu13082811Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational StudyCorrado Pelaia0Daniele Pastori1Giuseppe Armentaro2Sofia Miceli3Velia Cassano4Keti Barbara5Giulia Pelaia6Maria Perticone7Raffaele Maio8Pasquale Pignatelli9Francesco Violi10Francesco Perticone11Giorgio Sesti12Angela Sciacqua13Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyDepartment of Clinical and Molecular Medicine, Sapienza University of Rome, 00161 Rome, ItalyDepartment of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100 Catanzaro, ItalyBackground. 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 m<sup>2</sup>, and the rapid decline of eGFR >5 mL/min/1.73 m<sup>2</sup>/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 FEV<sub>1</sub>. 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, <i>p</i> < 0.0001) and diabetes (HR 1.050, <i>p</i> < 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, <i>p</i> < 0.0001)), an increase of 10 mL/min/1.73 m<sup>2</sup> in baseline eGFR (OR 1.054, <i>p</i> < 0.0001) and the presence of diabetes (OR 1.100, <i>p</i> < 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.https://www.mdpi.com/2072-6643/13/8/2811COPDuric aciddiabetesrenal failureoxidative stress |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Corrado Pelaia Daniele Pastori Giuseppe Armentaro Sofia Miceli Velia Cassano Keti Barbara Giulia Pelaia Maria Perticone Raffaele Maio Pasquale Pignatelli Francesco Violi Francesco Perticone Giorgio Sesti Angela Sciacqua |
spellingShingle |
Corrado Pelaia Daniele Pastori Giuseppe Armentaro Sofia Miceli Velia Cassano Keti Barbara Giulia Pelaia Maria Perticone Raffaele Maio Pasquale Pignatelli Francesco Violi Francesco Perticone Giorgio Sesti Angela Sciacqua Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study Nutrients COPD uric acid diabetes renal failure oxidative stress |
author_facet |
Corrado Pelaia Daniele Pastori Giuseppe Armentaro Sofia Miceli Velia Cassano Keti Barbara Giulia Pelaia Maria Perticone Raffaele Maio Pasquale Pignatelli Francesco Violi Francesco Perticone Giorgio Sesti Angela Sciacqua |
author_sort |
Corrado Pelaia |
title |
Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study |
title_short |
Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study |
title_full |
Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study |
title_fullStr |
Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study |
title_full_unstemmed |
Predictors of Renal Function Worsening in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Multicenter Observational Study |
title_sort |
predictors of renal function worsening in patients with chronic obstructive pulmonary disease (copd): a multicenter observational study |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2021-08-01 |
description |
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 m<sup>2</sup>, and the rapid decline of eGFR >5 mL/min/1.73 m<sup>2</sup>/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 FEV<sub>1</sub>. 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, <i>p</i> < 0.0001) and diabetes (HR 1.050, <i>p</i> < 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, <i>p</i> < 0.0001)), an increase of 10 mL/min/1.73 m<sup>2</sup> in baseline eGFR (OR 1.054, <i>p</i> < 0.0001) and the presence of diabetes (OR 1.100, <i>p</i> < 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. |
topic |
COPD uric acid diabetes renal failure oxidative stress |
url |
https://www.mdpi.com/2072-6643/13/8/2811 |
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