Chronic renal failure common in COPD patients
MedWire News: Chronic renal failure (CRF) is highly prevalent but under-recognized in patients with chronic obstructive pulmonary disease (COPD), say Italian researchers.
“CRF rises in prevalence with age and is frequently associated with chronic diseases such as congestive heart failure and diabetes mellitus,” explain Andrea Corsonello (Istituto Nazionale di Ricovero e Cura per Anziani, Cosenza) and team in the journal Chest.
But they add: “To the best of our knowledge, the association between COPD and CRF has never been assessed.”
To address this, the researchers studied data on 356 outpatients, aged at least 65 years, with COPD enrolled in the Extrapulmonary Consequences of COPD in the Elderly Study and 290 age-matched controls without the respiratory condition.
Normal renal function was defined as a glomerular filtration rate (GFR) of at least 60 ml/min/1.73 m2, concealed CRF as reduced GFR but normal serum creatinine levels, and overt CRF as reduced GFR and increased serum creatinine levels.
The researchers found that 20.8% and 22.2% of COPD patients had concealed and overt CRF, respectively, compared with just 10.0% and 13.4% of controls. Indeed, COPD patients were 2.19 times more likely to have concealed CRF and 194 times more likely to have overt CRF than controls.
Increasing age was also a significant risk factor for CRF, as was diabetes (odds ratio [OR]= 1.96), hypoalbuminemia (OR=2.83), and musculoskeletal diseases (OR=1.78). The presence of diabetes was particularly associated with overt CRF (OR=2.25), the researchers note.
Corsonello and team conclude: “CRF should be considered a common comorbidity of COPD, and it should be screened for because its recognition might either directly affect clinical practice (eg, drug prescribing and dosing) or have prognostic implications.”
They add: “Within the context of the rising interest in systemic features of COPD and related comorbidities, CRF should not be ignored or underestimated simply because it frequently cannot be recognized on the basis of serum creatinine.”
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By Mark Cowen