Impact of chronic kidney disease among Korean adults with chronic obstructive pulmonary disease

Min Young Kim, Sungmin Boo, Mijung Yoo, Jonghyun Lee, Na Ree Kang

Chronic kidney disease (CKD) is an emerging issue in patients with chronic obstructive pulmonary disease (COPD). In COPD, loss of muscle mass is relatively common finding, and diagnosis of CKD should be based on measured or estimated GFR (Cavailles et al. Eur Respir Rev 22:454-475, 2013; Gosker et al. Am J Clin Nutr 71:1033-1047, 2000; Delanaye and Mariat Nat Rev Nephrol 9:513-522, 2013). We aimed to determine the prevalence and impact of CKD, defined by using chronic kidney disease epidemiology collaboration (CKD-EPI) equation, in COPD patients. This study analyzed data of 3393 adults 40 years of age or older who completed pulmonary function tests in the fifth Korea National Health and Nutritional Examination Survey 2012. Participants with normal lung function (NLF) and COPD were included. CKD was defined as an eGFR <60 mL/min/1.73 m(2). Multivariate logistic regression analysis was performed to evaluate the relationship between CKD and COPD. Among 3393 participants, 528 (15.6%) were classified as COPD. The prevalence values of participants with eGFR level ≥90, 60-90, and <60 mL/min/1.73 m(2) were 54.1, 43.6, and 2.2% in those with NLF and 39.8, 51.5, and 8.7% in those with COPD (p = 0.000). We analyzed the relationship between COPD and all factors that had a statistically significant association with COPD. The significant factors were older age, lower education, BMI, pulmonary tuberculosis, current bronchial asthma, smoking, and CKD. In a Korean population ≥40 years old, the prevalence of participants with COPD is 15.6%. CKD is an independent risk factor for COPD. In addition to CKD, older age, lower education, BMI, pulmonary tuberculosis, current bronchial asthma, and smoking are significantly associated with COPD.