160 -11 (73) 2024 - Kenjaeva N.A. - CLINICAL AND LABORATORY ASPECTS OF THE DEVELOPMENT OF NEPHROPATHY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

CLINICAL AND LABORATORY ASPECTS OF THE DEVELOPMENT OF NEPHROPATHY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Kenjaeva N.A. - Bukhara State Medical Institute named after Abu Ali ibn Sina

Resume

The aim of the study was to investigate a relationship between frequency of exacerbations of chronic obstructive pulmonary disease (COPD) and renal dysfunction in patients with COPD. Methods. We examined 200 patients with COPD diagnosed according to GOLD, 2015. The patients were divided into 4 groups according to a rate of exacerbations of COPD and severity of symptoms. A and B groups had rare exacerbations (≤ 1 per year), C and D groups had frequent exacerbations (≥ 2 per year). Patients in A and D groups experienced less symptoms of COPD and patients in B and C groups had more symptoms. To investigate the renal function, glomerular filtration rate (GFR) was calculated in all patients twice during 6 months using the СKD-EPI formula; also, albuminuria (AU) was measured and renal ultrasonography was performed. Results. Pathological kidney disorders were found in 106 patients (53%). Positive correlations were found between the renal resistance index (RI) and FEV1 and between RI and age of the patients. Inverse correlations were found between FEV1 and increased AU and between frequency of exacerbations and AU. Chronic kidney disease (CKD) was diagnosed in 105 patients with COPD (52.5%). A persistent decrease in GFR < 60 ml/min/1.73m2 was revealed in 74 patients with COPD (37.0%). Stage I – II CKD was diagnosed in 31 of 126 COPD patients with normal or slightly decreased GFR (15.5%). Thus, stage I CKD was diagnosed in 13 patients with COPD (6.5%), stage II CKD was diagnosed in 18 patients (9.0%), stage III A CKD was diagnosed in 54 patients (27.0%), stage III B CKD was diagnosed in 16 patients (8.0%), and stage IV CKD was diagnosed in 4 patients (2.0%). Conclusions. CKD was diagnosed in 52.5% of patients with COPD. The prevalence of CKD was significantly higher in C and D groups. Stage III – IV CKD was diagnosed in patients with frequent exacerbations of COPD significantly more often. Clinically significant AU could be related to higher cardiovascular risk. Renal dysfunction in COPD patients could be due to endothelial dysfunction and systemic effects of COPD.

Key words: chronic kidney disease, chronic obstructive pulmonary disease, exacerbation of COPD.

First page

928

Last page

934

For citation:Kenjaeva N.A. - CLINICAL AND LABORATORY ASPECTS OF THE DEVELOPMENT OF NEPHROPATHY IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE//New Day in Medicine 11(73)2024 928-934 https://https://newdayworldmedicine.com/en/new_day_medicine/11-73-2024

List of References

  1. Report GOLD: Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. http://www.goldcopd.org. January 2015.
  2. Campo G., Pavasini R., Malagù M. et al. Chronic obstructive pulmonary disease and ischemic heart disease comorbidity: overview of mechanisms and clinical management. //Cardiovasc. Drugs Ther. 2015;29(2):147-157. DOI: 10.1007/s10557-014-6569-y.
  3. Чучалин А.Г., Авдеев С.Н., Айсанов З.Р. и др. Российское респираторное общество. Федеральные клинические рекомендации по диагностике и лечению хронической обструктивной болезни легких. //Пульмонология. 2014;3:15-54.
  4. Fabbian F., De Giorgi A., Manfredini F. et al. Impact of renal dysfunction on in-hospital mortality of patients with severe chronic obstructive pulmonary disease: a single-center Italian study. Int. Urol. Nephrol. 2016;48(7):1121-1127. DOI: 10.1007/s11255-016-1272-5.
  5. Болотова Е.В., Дудникова А.В. Особенности факторов риска хронической болезни почек у пациентов с хронической обструктивной болезнью легких. //Нефрология. 2015;19(5):28-33.
  6. Смирнов А.В., Шилов Е.М., Добронравов В.А. et al. Хроническая болезнь почек: основные принципы скрининга, диагностики, профилактики и подходы к лечению. Национальные рекомендации. //Нефрология. 2012;16(1):89-115.
  7. Johnston O., Cassidy H., O'Connell S. et al. Identification of beta-2-microglobulin as a urinary biomarker for chronic allograft nephropathy. //Proteomics Clin. Appl. 2011;5(7-8):422-431.
  8. Rubinsztajn R., Chazan R. Mortality and comorbidity in hospitalized chronic obstructive pulmonary disease patients. //Pneumonol. Alergol. Pol. 2011;79(5):343-346.
  9. Mallamaci F. Highlights of the 2015 ERA-EDTA congress: chronic kidney disease, hypertension. //Nephrol. Dial. Transplant. 2016;31(7):1044-1046. DOI: 10.1093/ndt/gfw006.
  10. Болотова Е.В., Дудникова А.В., Каменева Е.С. и др. Выявление начальных стадий хронической болезни почек при профилактических медицинских осмотрах: анализ факторов риска и расчет скорости клубочковой фильтрации по CKD-EPI. //Нефрология и диализ. 2015;17(4):445-451.
  11. Low S.K., Sum C.F., Yeoh L.Y. et al. Prevalence of chronic kidney disease in adults with type 2 diabetes mellitus. //Ann. Acad. Med. Singapore. 2015;44(5):164-171.
  12. Hallan S.I., Orth S.R. The KDOQI 2002 classification of chronic kidney disease: for whom the bell tolls. //Nephrol. Dial. Transplant. 2010;25:2832-2836.
  13. Tanaka F., Komi R., Makita S. et al. Low-grade albuminuria and incidence of cardiovascular disease and all-cause mortality in nondiabetic and normotensive individuals. //J. Hypertens. 2016;34(3):506-512.
  14. Masson S., Latini R., Milani V. et al. Prevalence and prognostic value of elevated urinary albumin excretion in patients with chronic heart failure: data from the GISSIHeart Failure trial. //Circ. Heart Fail. 2010;3(1):65-72. DOI:10.1161/CIRCHEARTFAILURE.109.881805.
  15. Bulcun E., Ekici M., Ekici A., Kisa U. Microalbuminuria in chronic obstructive pulmonary disease. //COPD. 2013;10(2):186-192.
  16. Rodriguez-Miguelez P., Seigler N., Bass L. et al. Assessments of endothelial function and arterial stiffness are reproducible in patients with COPD. //Int. J. Chron. Obstruct. Pulm. Dis. 2015;10:1977-1986. DOI: 10.2147/COPD. S92775.
  17. Matsumoto T., Murase K., Tachikawa R. et al. Microalbuminuria in patients with obstructive sleep apnea-chronic obstructive pulmonary disease overlap syndrome. //Ann. Am. Thorac. Soc. 2016;13(6):917-925. DOI: 10.1513/ AnnalsATS.201510-655OC.

    file

    download