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支气管哮喘与慢性肾脏病风险增加相关。

Bronchial asthma is associated with increased risk of chronic kidney disease.

作者信息

Huang Hui-Ling, Ho Shinn-Ying, Li Chien-Hsun, Chu Fang-Ying, Ciou Li-Ping, Lee Hua-Chin, Chen Wen-Liang, Tzeng Nian-Sheng

机构信息

Department of Psychiatry, Tri-Service General Hospital, School of Medicine and Student Counseling Center, National Defense Medical Center, #325, Sec 2, Cheng-Gong RdNei- Hu District, Taipei City, Taiwan.

出版信息

BMC Pulm Med. 2014 May 8;14:80. doi: 10.1186/1471-2466-14-80.

Abstract

BACKGROUND

Bronchial asthma influences some chronic diseases such as coronary heart disease, diabetes mellitus, and hypertension, but the impact of asthma on vital diseases such as chronic kidney disease is not yet verified. This study aims to clarify the association between bronchial asthma and the risk of developing chronic kidney disease.

METHODS

The National Health Research Institute provided a database of one million random subjects for the study. A random sample of 141 064 patients aged ≥18 years without a history of kidney disease was obtained from the database. Among them, there were 35 086 with bronchial asthma and 105 258 without asthma matched for sex and age for a ration of 1:3. After adjusting for confounding risk factors, a Cox proportional hazards model was used to compare the risk of developing chronic kidney disease during a three-year follow-up period.

RESULTS

Of the subjects with asthma, 2 196 (6.26%) developed chronic kidney disease compared to 4 120 (3.91%) of the control subjects. Cox proportional hazards regression analysis revealed that subjects with asthma were more likely to develop chronic kidney disease (hazard ratio [HR]: 1.56; 95% CI: 1.48-1.64; p < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region, diabetes mellitus, hypertension, hyperlipidemia, and steroid use, the HR for asthma patients was 1.40 (95% CI: 1.33-1.48; p = 0.040). There was decreased HRs in steroid use (HR: 0.56; 95% CI: 0.62-0.61; p < 0.001) in the development of chronic kidney disease. Expectorants, bronchodilators, anti-muscarinic agents, airway smooth muscle relaxants, and leukotriene receptor antagonists may also be beneficial in attenuating the risk of chronic kidney disease.

CONCLUSIONS

Patients with bronchial asthma may have increased risk of developing chronic kidney disease. The use of steroids or non-steroidal drugs in the treatment of asthma may attenuate this risk.

摘要

背景

支气管哮喘会影响一些慢性疾病,如冠心病、糖尿病和高血压,但哮喘对诸如慢性肾病等重大疾病的影响尚未得到证实。本研究旨在阐明支气管哮喘与患慢性肾病风险之间的关联。

方法

国家卫生研究院提供了一个包含100万随机受试者的数据库用于该研究。从数据库中获取了141064名年龄≥18岁且无肾病病史的患者的随机样本。其中,有35086名患有支气管哮喘,105258名无哮喘,按1:3的比例进行性别和年龄匹配。在调整混杂风险因素后,使用Cox比例风险模型比较三年随访期内患慢性肾病的风险。

结果

哮喘患者中有2196名(6.26%)患慢性肾病,而对照组为4120名(3.91%)。Cox比例风险回归分析显示,哮喘患者患慢性肾病的可能性更高(风险比[HR]:1.56;95%置信区间:1.48 - 1.64;p < 0.001)。在调整性别、年龄、月收入、城市化水平、地理区域、糖尿病、高血压、高脂血症和类固醇使用情况后,哮喘患者的HR为1.40(95%置信区间:1.33 - 1.48;p = 0.040)。在慢性肾病的发生中,类固醇使用的HR降低(HR:0.56;95%置信区间:0.62 - 0.61;p < 0.001)。祛痰剂、支气管扩张剂、抗毒蕈碱药物、气道平滑肌松弛剂和白三烯受体拮抗剂在降低慢性肾病风险方面可能也有益处。

结论

支气管哮喘患者患慢性肾病的风险可能增加。在哮喘治疗中使用类固醇或非甾体类药物可能会降低这种风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5986/4022436/571d0864e314/1471-2466-14-80-1.jpg

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