The association between COPD and outcomes of patients with advanced chronic kidney disease
Received 15 May 2018
Accepted for publication 23 July 2018
Published 17 September 2018 Volume 2018:13 Pages 2899—2905
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Chunxue Bai
Chih-Cheng Lai,1 Che-Hsiung Wu,2,3 Ya-Hui Wang,4 Cheng-Yi Wang,4 Vin-Cent Wu,5 Likwang Chen6
1Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan; 2Division of Nephrology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan; 3School of Medicine, Tzu Chi University, Hualien, Zhunan, Taiwan; 4Medical Research Center, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan; 5Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; 6Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
Objective: The aim of this study was to investigate the impact of COPD on the outcomes of patients with advanced chronic kidney disease (CKD).
Patients and methods: All patients with advanced CKD from 2000 to 2010 were identified from the Taiwanese National Health Insurance Research Database. Associations between COPD and the risk of long-term dialysis and all-cause mortality were assessed.
Results: A total of 33,399 advanced CKD patients were enrolled, of whom 31,536 did not have COPD (non-COPD group) and 1,863 had COPD (COPD group). The incidence of end-stage renal disease (ESRD) was higher for those with COPD than those without COPD (744.2 per 1,000 person-years vs 724.6 per 1,000 person-years, adjusted HR [aHR] 1.04; 95% CI 0.96–1.12). The cumulative incidence rates of ESRD were similar between the COPD and non-COPD groups (log-rank test, P=0.356). Overall, the patients with COPD had a higher risk of death than those without COPD (151.7 per 1,000 person-years vs 125.5 per 1,000 person-years, aHR 1.22; 95% CI 1.11–1.33). The cumulative mortality rate was higher in the COPD group than in the non-COPD group (log-rank test, P<0.001).
Conclusion: COPD increased the risk of mortality among the advanced CKD patients in this study, especially the elderly and male patients. In contrast, COPD did not increase the risk of ESRD among the advanced CKD patients.
Keywords: COPD, CKD, ESRD, mortality
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