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慢性肾脏病对韩国慢性阻塞性肺疾病成年患者的影响。

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

作者信息

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

机构信息

Department of Internal Medicine, Seoul Medical Center, 156 Sinnae-ro, Jungnang-gu, Seoul, 131-865, Korea.

出版信息

Int Urol Nephrol. 2017 Jul;49(7):1225-1232. doi: 10.1007/s11255-017-1572-4. Epub 2017 Apr 6.

Abstract

PURPOSE

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.

METHODS

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. Multivariate logistic regression analysis was performed to evaluate the relationship between CKD and COPD.

RESULTS

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 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.

CONCLUSIONS

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.

摘要

目的

慢性肾脏病(CKD)在慢性阻塞性肺疾病(COPD)患者中是一个新出现的问题。在COPD中,肌肉量减少是较为常见的表现,CKD的诊断应基于测量或估算的肾小球滤过率(GFR)(卡瓦耶等人,《欧洲呼吸杂志综述》22:454 - 475,2013年;戈斯克等人,《美国临床营养学杂志》71:1033 - 1047,2000年;德拉纳耶和马里亚,《自然综述:肾脏病学》9:513 - 522,2013年)。我们旨在确定采用慢性肾脏病流行病学协作组(CKD - EPI)方程定义的CKD在COPD患者中的患病率及影响。

方法

本研究分析了在2012年第五次韩国国家健康与营养检查调查中完成肺功能测试的3393名40岁及以上成年人的数据。纳入肺功能正常(NLF)和COPD患者。CKD定义为估算肾小球滤过率(eGFR)<60 mL/min/1.73 m²。进行多因素逻辑回归分析以评估CKD与COPD之间的关系。

结果

在3393名参与者中,528名(15.6%)被归类为COPD。eGFR水平≥90、60 - 90以及<60 mL/min/1.73 m²的参与者在NLF组中的患病率分别为54.1%、43.6%和2.2%,在COPD组中分别为39.8%、51.5%和8.7%(p = 0.000)。我们分析了COPD与所有与COPD有统计学显著关联的因素之间的关系。显著因素包括年龄较大、教育程度较低、体重指数、肺结核、当前支气管哮喘、吸烟和CKD。

结论

在年龄≥40岁的韩国人群中,COPD患者的患病率为15.6%。CKD是COPD的独立危险因素。除CKD外,年龄较大、教育程度较低、体重指数、肺结核、当前支气管哮喘和吸烟与COPD显著相关。

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