Acute kidney injury in stable COPD and at exacerbation
MF Barakat,1 HI McDonald,1 TJ Collier,1 L Smeeth,1 D Nitsch,1 JK Quint1,2 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, 2Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial Col...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2015-09-01
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| Series: | International Journal of COPD |
| Online Access: | https://www.dovepress.com/acute-kidney-injury-in-stable-copd-and-at-exacerbation-peer-reviewed-article-COPD |
| _version_ | 1811307617675378688 |
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| author | Barakat MF McDonald HI Collier TJ Smeeth L Nitsch D Quint JK |
| author_facet | Barakat MF McDonald HI Collier TJ Smeeth L Nitsch D Quint JK |
| author_sort | Barakat MF |
| collection | DOAJ |
| description | MF Barakat,1 HI McDonald,1 TJ Collier,1 L Smeeth,1 D Nitsch,1 JK Quint1,2 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, 2Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK Background: While acute kidney injury (AKI) alone is associated with increased mortality, the incidence of hospital admission with AKI among stable and exacerbating COPD patients and the effect of concurrent AKI at COPD exacerbation on mortality is not known.Methods: A total of 189,561 individuals with COPD were identified from the Clinical Practice Research Datalink. Using Poisson and logistic regressions, we explored which factors predicted admission for AKI (identified in Hospital Episode Statistics) in this COPD cohort and concomitant AKI at a hospitalization for COPD exacerbation. Using survival analysis, we investigated the effect of concurrent AKI at exacerbation on mortality (n=36,107) and identified confounding factors.Results: The incidence of AKI in the total COPD cohort was 128/100,000 person-years. The prevalence of concomitant AKI at exacerbation was 1.9%, and the mortality rate in patients with AKI at exacerbation was 521/1,000 person-years. Male sex, older age, and lower glomerular filtration rate predicted higher risk of AKI or death. There was a 1.80 fold (95% confidence interval: 1.61, 2.03) increase in adjusted mortality within the first 6 months post COPD exacerbation in patients suffering from AKI and COPD exacerbation compared to those who were AKI free.Conclusion: In comparison to previous studies on general populations and hospitalizations, the incidence and prevalence of AKI is relatively high in COPD patients. Coexisting AKI at exacerbation is prognostic of poor outcome. Keywords: acute renal failure, mortality, emphysema, chronic bronchitis, prognosis |
| first_indexed | 2024-04-13T09:08:00Z |
| format | Article |
| id | doaj.art-16bdbf93420743e6ab07472260d6095a |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-04-13T09:08:00Z |
| publishDate | 2015-09-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-16bdbf93420743e6ab07472260d6095a2022-12-22T02:52:57ZengDove Medical PressInternational Journal of COPD1178-20052015-09-012015Issue 12067207723853Acute kidney injury in stable COPD and at exacerbationBarakat MFMcDonald HICollier TJSmeeth LNitsch DQuint JKMF Barakat,1 HI McDonald,1 TJ Collier,1 L Smeeth,1 D Nitsch,1 JK Quint1,2 1Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, 2Department of Respiratory Epidemiology, Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College London, London, UK Background: While acute kidney injury (AKI) alone is associated with increased mortality, the incidence of hospital admission with AKI among stable and exacerbating COPD patients and the effect of concurrent AKI at COPD exacerbation on mortality is not known.Methods: A total of 189,561 individuals with COPD were identified from the Clinical Practice Research Datalink. Using Poisson and logistic regressions, we explored which factors predicted admission for AKI (identified in Hospital Episode Statistics) in this COPD cohort and concomitant AKI at a hospitalization for COPD exacerbation. Using survival analysis, we investigated the effect of concurrent AKI at exacerbation on mortality (n=36,107) and identified confounding factors.Results: The incidence of AKI in the total COPD cohort was 128/100,000 person-years. The prevalence of concomitant AKI at exacerbation was 1.9%, and the mortality rate in patients with AKI at exacerbation was 521/1,000 person-years. Male sex, older age, and lower glomerular filtration rate predicted higher risk of AKI or death. There was a 1.80 fold (95% confidence interval: 1.61, 2.03) increase in adjusted mortality within the first 6 months post COPD exacerbation in patients suffering from AKI and COPD exacerbation compared to those who were AKI free.Conclusion: In comparison to previous studies on general populations and hospitalizations, the incidence and prevalence of AKI is relatively high in COPD patients. Coexisting AKI at exacerbation is prognostic of poor outcome. Keywords: acute renal failure, mortality, emphysema, chronic bronchitis, prognosishttps://www.dovepress.com/acute-kidney-injury-in-stable-copd-and-at-exacerbation-peer-reviewed-article-COPD |
| spellingShingle | Barakat MF McDonald HI Collier TJ Smeeth L Nitsch D Quint JK Acute kidney injury in stable COPD and at exacerbation International Journal of COPD |
| title | Acute kidney injury in stable COPD and at exacerbation |
| title_full | Acute kidney injury in stable COPD and at exacerbation |
| title_fullStr | Acute kidney injury in stable COPD and at exacerbation |
| title_full_unstemmed | Acute kidney injury in stable COPD and at exacerbation |
| title_short | Acute kidney injury in stable COPD and at exacerbation |
| title_sort | acute kidney injury in stable copd and at exacerbation |
| url | https://www.dovepress.com/acute-kidney-injury-in-stable-copd-and-at-exacerbation-peer-reviewed-article-COPD |
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