Chronic kidney disease: A likely underestimated component of multimorbidity in older patients with chronic obstructive pulmonary disease

Corsonello, Andrea; Aucella, Filippo; Pedone, Claudio; Antonelli-Incalzi, Raffaele

doi:10.1111/ggi.13054

Cited by 19 publications

(14 citation statements)

References 131 publications

(143 reference statements)

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“…Interestingly, renal impairment, which is seldom investigated in these patients, particularly in COPD, represents an important common risk factor of death. However, the mechanisms underlying this risk of mortality remain largely unknown due to the several gaps in our knowledge on the lung-heart and kidney interplay (41)(42)(43), suggesting the need for further basic and clinical research on this topic.…”

Section: Discussionmentioning

confidence: 99%

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

et al. 2018

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Background: In elderly smokers, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) usually present with dyspnoea. COPD and CHF are associated almost invariably with concomitant chronic diseases, which contribute to severity and prognosis. Objectives: We investigated similarities and differences in the clinical presentation, concomitant chronic diseases and risk factors for mortality and hospitalization at 3-year follow-up in elderly smokers/ex-smokers with a primary diagnosis of COPD or CHF recruited and followed in specialized centers. Methods: We examined 144 patients with COPD and 96 with CHF, ≥65 years, ≥20 pack/years, and measured COPD Assessment Test (CAT) score, modified Medical Research Council, NYHA, and Charlson Index, routine blood test, estimated glomerular filtration rate, HRCT scan, 6-min walk test. In addition, in each patient we actively searched for CHF, COPD, peripheral vascular disease, and metabolic syndrome. Results: COPD and CHF patients had mild to moderate disease, but the majority was symptomatic. Comorbidities were highly prevalent and often unrecognized in both groups. COPD and CHF patients had a similar risk of hospitalization and death at 3 years. Lower glomerular filtration rate, shorter 6MWT, and ascending aorta calcification score ≥2 were independent predictors of mortality in COPD, whereas previous 12 months hospitalizations, renal disease, and heart diameter were in CHF patients. Lower glomerular filtration rate value, higher CAT score, and lower FEV₁/FVC ratio were associated with hospitalization in COPD, while age, lower FEV₁% predicted, and peripheral vascular disease were in CHF. Conclusions: There are relevant similarities and differences between patients with COPD and CHF even when admitted to specialized outpatient centers, suggesting that these patients should be manage in multidisciplinary units.

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Section: Discussionmentioning

confidence: 99%

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

et al. 2018

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“…CKD is a risk factor for mortality in patients with COPD and levels of albumin‐to‐creatinine ratio is associated with all‐cause mortality in these patients. Also, patients with COPD who begin dialysis have a higher risk of mortality and lower rates of kidney transplantation …”

Section: Comorbiditiesmentioning

confidence: 99%

“…Also, patients with COPD who begin dialysis have a higher risk of mortality and lower rates of kidney transplantation. 134…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

Risk factors of chronic obstructive pulmonary disease exacerbations

Hogea

Tudorache

Fildan

et al. 2020

Clinical Respiratory J

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Chronic Obstructive Pulmonary Disease (COPD) is a chronic respiratory disease characterised by persistent respiratory symptoms and airflow limitation. COPD has a major impact on public health, mainly because of its increasing prevalence, morbidity and mortality. The natural course of COPD is aggravated by episodes of respiratory symptom worsening termed exacerbations that contribute to disease progression. Acute Exacerbations of COPD (AECOPD) can be triggered by a multitude of different factors, including respiratory tract infections, various exposures, prior exacerbations, non‐adherence to treatment and associated comorbidities. AECOPD are associated with an inexorable decline of lung function and a significantly worse survival outcome. This review will summarise the most important aspects regarding the impact of different factors that contribute to COPD exacerbations.

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“…These mechanisms affect kidney structures and translate into relevant functional changes (Fig. 1) [3, 8, 9]. …”

Section: Renal Ageing Vs Progressive Nephropathymentioning

confidence: 99%

Beyond chronic kidney disease: the diagnosis of Renal Disease in the Elderly as an unmet need. A position paper endorsed by Italian Society of Nephrology (SIN) and Italian Society of Geriatrics and Gerontology (SIGG)

et al. 2019

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The dramatic increase in prevalence of chronic kidney disease (CKD) with ageing makes the recognition and correct referral of these patients of paramount relevance in order to implement interventions preventing or delaying the development of CKD complications and end-stage renal disease. Nevertheless, several issues make the diagnosis of CKD in the elderly cumbersome. Among these are age related changes in structures and functions of the kidney, which may be difficult to distinguish from CKD, and multimorbidity. Thus, symptoms, clinical findings and laboratory abnormalities should be considered as potential clues to suspect CKD and to suggest screening. Comprehensive geriatric assessment is essential to define the clinical impact of CKD on functional status and to plan treatment. Correct patient referral is very important: patients with stage 4–5 CKD, as well as those with worsening proteinuria or progressive nephropathy (i.e. eGFR reduction > 5 ml/year) should be referred to nephrologist. Renal biopsy not unfrequently may be the key diagnostic exam and should not be denied simply on the basis of age. Indeed, identifying the cause(s) of CKD is highly desirable to perform a targeted therapy against the pathogenetic mechanisms of CKD, which complement and may outperform in efficacy the general measures for CKD.

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Chronic kidney disease: A likely underestimated component of multimorbidity in older patients with chronic obstructive pulmonary disease

Cited by 19 publications

References 131 publications

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

Three-Year Hospitalization and Mortality in Elderly Smokers with Chronic Obstructive Pulmonary Disease or Chronic Heart Failure

Risk factors of chronic obstructive pulmonary disease exacerbations

Beyond chronic kidney disease: the diagnosis of Renal Disease in the Elderly as an unmet need. A position paper endorsed by Italian Society of Nephrology (SIN) and Italian Society of Geriatrics and Gerontology (SIGG)

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