Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomes
Abstract Introduction Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common and preventable event in patients with chronic obstructive pulmonary disease (COPD). Data regarding the impact of AECOPD on short- and long-term renal outcomes are lacking. Methods We included all...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-023-02635-8 |
| _version_ | 1797349770792009728 |
|---|---|
| author | Wang Chun Kwok Terence C. C. Tam James C. M. Ho David C. L. Lam Mary S. M. Ip Desmond Y. H. Yap |
| author_facet | Wang Chun Kwok Terence C. C. Tam James C. M. Ho David C. L. Lam Mary S. M. Ip Desmond Y. H. Yap |
| author_sort | Wang Chun Kwok |
| collection | DOAJ |
| description | Abstract Introduction Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common and preventable event in patients with chronic obstructive pulmonary disease (COPD). Data regarding the impact of AECOPD on short- and long-term renal outcomes are lacking. Methods We included all COPD patients who were followed at Queen Mary Hospital (QMH) in year 2015 and reviewed their clinical/renal outcomes in subsequent five years. Relationships between AECOPD and adverse renal outcomes were evaluated. Results 371 COPD patients were included. 169 patients had hospitalized AECOPD in past one year (HAE group) while 202 patients did not (non-HAE group). 285 patients (76.8%) had renal progression/death and 102 (27.5%) patients developed acute kidney injury (AKI). HAE group showed a more rapid eGFR decline than non-HAE group (-4.64 mL/min/1.73m2/year vs. -2.40 mL/min/1.73m2/year, p = 0.025). HAE group had significantly higher risk for renal progression/death at 5 years [adjusted OR (aOR) 2.380 (95% CI = 1.144–4.954), p = 0.020]. The frequency of hospitalized AECOPD in past 3 years, any AECOPD in past 3 years, hospitalized AECOPD in past 3 years were also predictive of renal progression/death at 5 years [aOR were 1.176 (95% CI = 1.038– 1.331), 2.998 (95% CI = 1.438–6.250) and 2.887 (95% CI = 1.409–5.917) respectively; p = 0.011, 0.003 and 0.004]. HAE group also showed significantly higher risk of AKI [adjusted HR (aHR) 2.430; 95% CI = 1.306–4.519, p = 0.005]. Conclusions AECOPD, in particular HAE, was associated with increased risk of renal progression/death and AKI. Prevention of AECOPD, especially HAE, may potentially improve short- and long-term renal outcomes in COPD patients. |
| first_indexed | 2024-03-08T12:35:15Z |
| format | Article |
| id | doaj.art-425fcc5c007d40f48f3a40e18ad4ec13 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-03-08T12:35:15Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-425fcc5c007d40f48f3a40e18ad4ec132024-01-21T12:31:17ZengBMCRespiratory Research1465-993X2024-01-012511810.1186/s12931-023-02635-8Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomesWang Chun Kwok0Terence C. C. Tam1James C. M. Ho2David C. L. Lam3Mary S. M. Ip4Desmond Y. H. Yap5Division of Respiratory Medicine, The University of Hong KongDivision of Respiratory Medicine, The University of Hong KongDivision of Respiratory Medicine, The University of Hong KongDivision of Respiratory Medicine, The University of Hong KongDivision of Respiratory Medicine, The University of Hong KongDivision of Nephrology, Department of Medicine, Queen Mary Hospital, the University of Hong Kong, Hong Kong Special Administrative RegionAbstract Introduction Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common and preventable event in patients with chronic obstructive pulmonary disease (COPD). Data regarding the impact of AECOPD on short- and long-term renal outcomes are lacking. Methods We included all COPD patients who were followed at Queen Mary Hospital (QMH) in year 2015 and reviewed their clinical/renal outcomes in subsequent five years. Relationships between AECOPD and adverse renal outcomes were evaluated. Results 371 COPD patients were included. 169 patients had hospitalized AECOPD in past one year (HAE group) while 202 patients did not (non-HAE group). 285 patients (76.8%) had renal progression/death and 102 (27.5%) patients developed acute kidney injury (AKI). HAE group showed a more rapid eGFR decline than non-HAE group (-4.64 mL/min/1.73m2/year vs. -2.40 mL/min/1.73m2/year, p = 0.025). HAE group had significantly higher risk for renal progression/death at 5 years [adjusted OR (aOR) 2.380 (95% CI = 1.144–4.954), p = 0.020]. The frequency of hospitalized AECOPD in past 3 years, any AECOPD in past 3 years, hospitalized AECOPD in past 3 years were also predictive of renal progression/death at 5 years [aOR were 1.176 (95% CI = 1.038– 1.331), 2.998 (95% CI = 1.438–6.250) and 2.887 (95% CI = 1.409–5.917) respectively; p = 0.011, 0.003 and 0.004]. HAE group also showed significantly higher risk of AKI [adjusted HR (aHR) 2.430; 95% CI = 1.306–4.519, p = 0.005]. Conclusions AECOPD, in particular HAE, was associated with increased risk of renal progression/death and AKI. Prevention of AECOPD, especially HAE, may potentially improve short- and long-term renal outcomes in COPD patients.https://doi.org/10.1186/s12931-023-02635-8Acute exacerbationAcute kidney injuryChronic Obstructive Pulmonary DiseaseChronic Kidney Disease |
| spellingShingle | Wang Chun Kwok Terence C. C. Tam James C. M. Ho David C. L. Lam Mary S. M. Ip Desmond Y. H. Yap Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomes Respiratory Research Acute exacerbation Acute kidney injury Chronic Obstructive Pulmonary Disease Chronic Kidney Disease |
| title | Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomes |
| title_full | Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomes |
| title_fullStr | Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomes |
| title_full_unstemmed | Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomes |
| title_short | Hospitalized acute exacerbation in chronic obstructive pulmonary disease – impact on long-term renal outcomes |
| title_sort | hospitalized acute exacerbation in chronic obstructive pulmonary disease impact on long term renal outcomes |
| topic | Acute exacerbation Acute kidney injury Chronic Obstructive Pulmonary Disease Chronic Kidney Disease |
| url | https://doi.org/10.1186/s12931-023-02635-8 |
| work_keys_str_mv | AT wangchunkwok hospitalizedacuteexacerbationinchronicobstructivepulmonarydiseaseimpactonlongtermrenaloutcomes AT terencecctam hospitalizedacuteexacerbationinchronicobstructivepulmonarydiseaseimpactonlongtermrenaloutcomes AT jamescmho hospitalizedacuteexacerbationinchronicobstructivepulmonarydiseaseimpactonlongtermrenaloutcomes AT davidcllam hospitalizedacuteexacerbationinchronicobstructivepulmonarydiseaseimpactonlongtermrenaloutcomes AT marysmip hospitalizedacuteexacerbationinchronicobstructivepulmonarydiseaseimpactonlongtermrenaloutcomes AT desmondyhyap hospitalizedacuteexacerbationinchronicobstructivepulmonarydiseaseimpactonlongtermrenaloutcomes |