Acute kidney injury in stable COPD and at exacerbation
Open Access
- 1 September 2015
- journal article
- research article
- Published by Taylor & Francis Ltd in International Journal of Chronic Obstructive Pulmonary Disease
- Vol. 10 (1), 2067-2077
- https://doi.org/10.2147/copd.s88759
Abstract
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
This publication has 25 references indexed in Scilit:
- Chronic Kidney DiseaseClinical Journal of the American Society of Nephrology, 2010
- Chronic Renal FailureSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2010
- A New Equation to Estimate Glomerular Filtration RateAnnals of Internal Medicine, 2009
- Exacerbation rate, health status and mortality in COPD – a review of potential interventionsInternational Journal of Chronic Obstructive Pulmonary Disease, 2009
- The risk of acute renal failure in patients with chronic kidney diseaseKidney International, 2008
- Epidemiology of Acute Kidney InjuryClinical Journal of the American Society of Nephrology, 2008
- Complex chronic comorbidities of COPDEuropean Respiratory Journal, 2008
- COPD exacerbations: defining their cause and preventionThe Lancet, 2007
- Global burden of COPD: systematic review and meta-analysisEuropean Respiratory Journal, 2006
- Abnormalities of Renal Endothelin during Acute Exacerbation in Chronic Obstructive Pulmonary DiseasePulmonary Pharmacology & Therapeutics, 2001