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慢性阻塞性肺疾病(COPD)与慢性肾脏病(CKD)之间的关联:一项系统评价与荟萃分析

Association between COPD and CKD: a systematic review and meta-analysis.

作者信息

Liu Zexin, Ma Zhimin, Ding Chaowei

机构信息

Department of Respiratory and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Respiratory and Critical Care Medicine, Xiamen Humanity Hospital Fujian Medical University, Xiamen, China.

出版信息

Front Public Health. 2024 Dec 16;12:1494291. doi: 10.3389/fpubh.2024.1494291. eCollection 2024.

Abstract

OBJECTIVE

Chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) are significant global health issues with a well-established association between the two. This study aims to assess the risk of developing CKD in patients with COPD through systematic review and meta-analysis, and to explore the impact of CKD on the prognosis of COPD patients.

METHODS

A total of 23 studies were included in the analysis, comprising 11 studies on the risk of CKD in patients with COPD, 6 studies on the impact of CKD on the short-term all-cause mortality risk of patients with acute exacerbation of COPD (AECOPD), and 6 studies on the impact of CKD on the long-term all-cause mortality risk of COPD patients. The meta-analysis showed that the risk of developing CKD in COPD patients was significantly increased (OR 1.54, 95% CI: 1.28-1.84), and CKD significantly increased the short-term all-cause mortality risk in AECOPD patients (OR 1.53, 95% CI: 1.44-1.63) as well as the long-term all-cause mortality risk in COPD patients (OR 1.70, 95% CI: 1.35-2.15).

RESULTS

We searched the PubMed, EMBASE, and Cochrane Library databases in accordance with the PRISMA guidelines, including studies from the inception of the databases through December 31, 2023, to identify research assessing the relationship between COPD and CKD. The quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). Data were analyzed using either a random effects model or a fixed effects model for the meta-analysis.

CONCLUSION

This study establishes a significant association between COPD and CKD and reveals the adverse impact of CKD on the prognosis of COPD patients, which may provide important guidance for clinical practice.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/.

摘要

目的

慢性阻塞性肺疾病(COPD)和慢性肾脏病(CKD)是重大的全球健康问题,两者之间存在已明确的关联。本研究旨在通过系统评价和荟萃分析评估COPD患者发生CKD的风险,并探讨CKD对COPD患者预后的影响。

方法

分析共纳入23项研究,其中11项研究探讨了COPD患者发生CKD的风险,6项研究评估了CKD对慢性阻塞性肺疾病急性加重(AECOPD)患者短期全因死亡风险的影响,6项研究评估了CKD对COPD患者长期全因死亡风险的影响。荟萃分析显示,COPD患者发生CKD的风险显著增加(比值比1.54,95%置信区间:1.28 - 1.84),CKD显著增加了AECOPD患者的短期全因死亡风险(比值比1.53,95%置信区间:1.44 - 1.63)以及COPD患者的长期全因死亡风险(比值比1.70,95%置信区间:1.35 - 2.15)。

结果

我们按照PRISMA指南检索了PubMed、EMBASE和Cochrane图书馆数据库,纳入从数据库建立至2023年12月31日期间评估COPD与CKD关系的研究。采用纽卡斯尔 - 渥太华量表(NOS)评估研究质量。荟萃分析采用随机效应模型或固定效应模型进行数据分析。

结论

本研究证实了COPD与CKD之间存在显著关联,并揭示了CKD对COPD患者预后的不良影响,这可能为临床实践提供重要指导。

系统评价注册

https://www.crd.york.ac.uk/PROSPERO/

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5286/11683117/fd6294886f19/fpubh-12-1494291-g001.jpg

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