Association between chronic obstructive pulmonary disease and chronic kidney disease in vascular surgery patients
Association between chronic obstructive pulmonary disease and chronic kidney disease in vascular surgery patients
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DOI：
10.1093/ndt/gfp171
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发表时间：
2009-09-01
影响因子：
6.1
通讯作者：
Poldermans, Don
中科院分区：
文献类型：
--
作者：
van Gestel, Yvette R. B. M.;Chonchol, Michel;Poldermans, Don
方法.我们对1990年至2006年间的3358例血管手术患者进行了队列研究。根据肾脏疾病饮食改良公式，CKD定义为肾小球滤过率（GFR）< 60 mL/min/1.73 m2。此外，根据基线估计的GFR将患者分为三类：>= 90 mL/min/1.73 m（2）; 60-89 mL/min/1.73 m（2）和< 60 mL/min/1.73 m（2）。采用多因素Logistic回归分析COPD与CKD的独立相关性。COPD患病率与肾功能呈负相关。在GFR < 60、60-89和>= 90 mL/min/1.73 m（2）的患者中，COPD的发生率分别为47%、38%和32%。COPD与CKD独立相关（OR 1.22; 95%CI 1.03-1.44; P = 0.03）。这种关联在中度COPD患者中最强（OR 1.33; 95% CI 1.07-1.65; P = 0.01）。与非COPD患者相比，中度和重度COPD均与CKD患者的长期死亡率增加相关（HR分别为1.27; 95% CI 1.03-1.56; P = 0.03和HR 1.61; 95% CI 1.10-2.35; P = 0.01）。我们的研究结果表明，在一个大的血管手术患者队列中，COPD与CKD中度相关。此外，中度和重度COPD与CKD患者的长期死亡率增加有关。
Methods. We conducted a cohort study of 3358 vascular surgery patients between 1990 and 2006. CKD was defined according to the Modification of Diet in Renal Disease equation as an estimated glomerular filtration rate (GFR) < 60 mL/min/1.73 m(2). In addition, the patients were divided into three categories based on the baseline estimated GFR: >= 90 mL/min/1.73 m(2); 60-89 mL/min/1.73 m(2) and < 60 mL/min/1.73 m(2). Multivariable logistic regression analysis was used to evaluate the independent association between prevalent COPD and CKD.Results. The prevalence of COPD was inversely related to kidney function. COPD was present in 47, 38 and 32% of patients with an estimated GFR < 60, 60-89 and >= 90 mL/min/1.73 m(2), respectively. COPD was independently associated with CKD (OR 1.22; 95% CI 1.03-1.44; P = 0.03). This association was strongest in patients with moderate COPD (OR 1.33; 95% CI 1.07-1.65; P = 0.01). Both moderate and severe COPD were associated with increased long-term mortality in patients with CKD (HR 1.27; 95% CI 1.03-1.56; P = 0.03 and HR 1.61; 95% CI 1.10-2.35; P = 0.01, respectively), compared to patients without COPD.Conclusions. Our findings indicate that COPD is moderately associated with CKD in a large cohort of vascular surgery patients. In addition, moderate and severe COPD are related to increased long-term mortality in patients with CKD.