Cargando…
Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease
BACKGROUND: Cardiovascular disease (CVD), protein-energy wasting (PEW), and inflammation are common interrelated features of chronic kidney disease (CKD). Less is known about lung dysfunction in CKD and its possible role in this context. We evaluated lung function and its association with estimated...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922538/ https://www.ncbi.nlm.nih.gov/pubmed/29702682 http://dx.doi.org/10.1371/journal.pone.0195585 |
_version_ | 1783318215413202944 |
---|---|
author | Mukai, Hideyuki Ming, Pei Lindholm, Bengt Heimbürger, Olof Barany, Peter Anderstam, Björn Stenvinkel, Peter Qureshi, Abdul Rashid |
author_facet | Mukai, Hideyuki Ming, Pei Lindholm, Bengt Heimbürger, Olof Barany, Peter Anderstam, Björn Stenvinkel, Peter Qureshi, Abdul Rashid |
author_sort | Mukai, Hideyuki |
collection | PubMed |
description | BACKGROUND: Cardiovascular disease (CVD), protein-energy wasting (PEW), and inflammation are common interrelated features of chronic kidney disease (CKD). Less is known about lung dysfunction in CKD and its possible role in this context. We evaluated lung function and its association with estimated glomerular filtration rate (GFR), CVD, PEW, and inflammation in individuals with normal to severely reduced GFR. METHODS: In 404 individuals with GFR category G1 (n = 31; GFR >90mL/min/1.73 m(2)), G2 (n = 46), G3 (n = 33), G4 (n = 49) and G5 (n = 245; GFR<15mL/min/1.73 m(2)), pulmonary function was assessed by spirometry. Obstructive (OLD) and restrictive (RLD) lung dysfunction was defined based on forced vital capacity (FVC), forced expiratory volume in the first second (FEV(1)) and peak expiratory flow (PEF), expressed as percentages of predicted values (%FEV(1), %FVC and %PEF, respectively). PEW was evaluated by subjective global assessment, handgrip strength (HGS) and lean body mass index (LBMI), and inflammation by interleukin-6 and high sensitivity C-reactive protein. RESULTS: RLD (defined as FEV(1)/FVC ≥ 0.70 and %FVC<80) associated with GFR and was present in 36% of G5 and 14% of G1-4 individuals. OLD (FEV(1)/FVC<0.70) was less common with similar prevalence among G1-4 (9%) and G5 (11%) individuals. Notably, 64% of those with concomitant presence of PEW, inflammation and clinical signs of CVD had RLD while 79% of those lacking these complications had normal lung function. In multivariate logistic regression analysis, RLD associated with CVD, PEW and inflammation, after adjusting for Framingham’s CVD risk score, serum albumin, and GFR category. CONCLUSIONS: RLD is a common complication in patients with advanced CKD, especially in those with concomitant presence of CVD, inflammation and PEW. RLD appears to be an integral albeit scarcely explored consequence of pulmonary-renal interactions in CKD patients. |
format | Online Article Text |
id | pubmed-5922538 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-59225382018-05-11 Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease Mukai, Hideyuki Ming, Pei Lindholm, Bengt Heimbürger, Olof Barany, Peter Anderstam, Björn Stenvinkel, Peter Qureshi, Abdul Rashid PLoS One Research Article BACKGROUND: Cardiovascular disease (CVD), protein-energy wasting (PEW), and inflammation are common interrelated features of chronic kidney disease (CKD). Less is known about lung dysfunction in CKD and its possible role in this context. We evaluated lung function and its association with estimated glomerular filtration rate (GFR), CVD, PEW, and inflammation in individuals with normal to severely reduced GFR. METHODS: In 404 individuals with GFR category G1 (n = 31; GFR >90mL/min/1.73 m(2)), G2 (n = 46), G3 (n = 33), G4 (n = 49) and G5 (n = 245; GFR<15mL/min/1.73 m(2)), pulmonary function was assessed by spirometry. Obstructive (OLD) and restrictive (RLD) lung dysfunction was defined based on forced vital capacity (FVC), forced expiratory volume in the first second (FEV(1)) and peak expiratory flow (PEF), expressed as percentages of predicted values (%FEV(1), %FVC and %PEF, respectively). PEW was evaluated by subjective global assessment, handgrip strength (HGS) and lean body mass index (LBMI), and inflammation by interleukin-6 and high sensitivity C-reactive protein. RESULTS: RLD (defined as FEV(1)/FVC ≥ 0.70 and %FVC<80) associated with GFR and was present in 36% of G5 and 14% of G1-4 individuals. OLD (FEV(1)/FVC<0.70) was less common with similar prevalence among G1-4 (9%) and G5 (11%) individuals. Notably, 64% of those with concomitant presence of PEW, inflammation and clinical signs of CVD had RLD while 79% of those lacking these complications had normal lung function. In multivariate logistic regression analysis, RLD associated with CVD, PEW and inflammation, after adjusting for Framingham’s CVD risk score, serum albumin, and GFR category. CONCLUSIONS: RLD is a common complication in patients with advanced CKD, especially in those with concomitant presence of CVD, inflammation and PEW. RLD appears to be an integral albeit scarcely explored consequence of pulmonary-renal interactions in CKD patients. Public Library of Science 2018-04-27 /pmc/articles/PMC5922538/ /pubmed/29702682 http://dx.doi.org/10.1371/journal.pone.0195585 Text en © 2018 Mukai et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Mukai, Hideyuki Ming, Pei Lindholm, Bengt Heimbürger, Olof Barany, Peter Anderstam, Björn Stenvinkel, Peter Qureshi, Abdul Rashid Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease |
title | Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease |
title_full | Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease |
title_fullStr | Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease |
title_full_unstemmed | Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease |
title_short | Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease |
title_sort | restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922538/ https://www.ncbi.nlm.nih.gov/pubmed/29702682 http://dx.doi.org/10.1371/journal.pone.0195585 |
work_keys_str_mv | AT mukaihideyuki restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease AT mingpei restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease AT lindholmbengt restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease AT heimburgerolof restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease AT baranypeter restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease AT anderstambjorn restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease AT stenvinkelpeter restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease AT qureshiabdulrashid restrictivelungdisorderiscommoninpatientswithkidneyfailureandassociateswithproteinenergywastinginflammationandcardiovasculardisease |