Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 15

Incidence, Risk Factors, and Prognostic Implications of Acute Kidney Injury in Patients with Acute Exacerbation of COPD

Authors Wan X, Chen D, Tan Y, Ma M, Zhang F, Liu Z, Chen Y, Shao W, Cao C

Received 12 November 2019

Accepted for publication 16 April 2020

Published 15 May 2020 Volume 2020:15 Pages 1085—1092

DOI https://doi.org/10.2147/COPD.S238343

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Chunxue Bai


Xin Wan,1,2,* Dawei Chen,1,* Yan Tan,3 Mengqing Ma,2 Feng Zhang,1 Zhihe Liu,1 Yue Chen,1 Wei Shao,2 Changchun Cao2

1Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 3Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Changchun Cao
Department of Nephrology, Sir Run Run Hospital, Nanjing Medical University, No. 109 Longmian Street, Nanjing, Jiangsu 211100, People’s Republic of China
Email caochangchun@njmu.edu.cn

Purpose: Little is known about the incidence, risk factors, and prognostic implications of acute kidney injury (AKI) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in China. In this study, we investigated the incidence, risk factors, and short-term outcomes of AKI in these patients.
Patients and Methods: We analyzed the records of 1768 patients admitted to Nanjing First Hospital with a principal diagnosis of AECOPD. Of these, 377 patients had AKI.
Results: AKI occurred in 377 patients (21%). Independent risk factors for AKI in patients with AECOPD were advanced age, coronary artery disease, anemia, cancer, chronic kidney disease, hypercapnic encephalopathy, acute respiratory failure, and mechanical ventilation. Patients with AKI had worse prognostic implications and were more likely to require mechanical ventilation (38.7% vs 19.1%, P< 0.001); non-invasive mechanical ventilation (38.2% vs 18.9%, P< 0.001); invasive mechanical ventilation (18.3% vs 3.1%, P< 0.001); intensive care unit (ICU) admission (33.7% vs 12.9%, P< 0.001); had a longer ICU stay (9 days vs 8 days, P=0.033) and longer hospitalization (13 days vs 10 days, P< 0.001); and higher in-hospital mortality (18.0% vs 2.7%, P< 0.001) than those without AKI. Multivariable analysis indicated that compared to patients without AKI, those with stage 1, 2, or 3 AKI had a 1.9-fold, 2.1-fold, or 6.0-fold increased risk of in-hospital death, respectively.
Conclusion: AKI is common in patients with AECOPD requiring hospitalization. Patients with AKI have worse short-term outcomes. Thus, AKI may be a prognostic predictor of patient survival.

Keywords: acute kidney injury, acute exacerbation of chronic obstructive pulmonary disease, incidence, risk factor, prognostic implication

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]