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제목	IMPACT OF CHRONIC KIDNEY DISEASE AMONG KOREANS ADULTS WITH CHRONIC OBSTUCTIVE PULMONARY DISEASE
저자	Jonghyun Lee* 1, Mijung Yoo1, Sungmin Boo1, Na Ree Kang1, Min Young Kim1
출판정보	2016; 2016(1):
키워드	chronic kidney disease , chronic obstructive pulmonary disease
초록	Background: Renal dysfunction is associated with increased in-hospital mortality in chronic obstructive pulmonary disease (COPD) patients. Early identification and intervention of COPD patients with chronic kidney disease (CKD) may provide better outcomes in the general population. However, there is little known about the relationship between CKD and COPD in the general population. We aimed to determine the prevalence and impact of CKD in COPD patients from the fifth Korea National Health and Nutritional Examination Survey (KNHANES V-3) 2012. Methods: This study analyzed data of 3393 adults ≥40 years old who completed pulmonary function tests. On spirometric examination, participants with FEV1/FVC ≥0.70 and FVC ≥80% predicted were categorized as having normal lung function (NLF). COPD was defined as FEV1/FVC <0.70. Participants with restrictive lung function of FEV1/FVC ≥0.70 and FVC <80% predicted were excluded from this study. Glomerular filtration rates (eGFRs) were evaluated using the equation described by the Chronic Kidney Disease Epidemiology Collaboration. CKD was defined as eGFR <60 mL/min/1.73m2. Multivariate logistic regression analysis was performed to evaluate the relationship between CKD and COPD. Results: Among 3027 participants, the prevalence of COPD was 17.4%. The prevalence of participants with eGFR level ≥90, 60-90, and <60 mL/min/1.73m2 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 (≥70 vs ≥40, OR 3.266, 95% CI 2.232-4.780), male (OR 5.014, 95% CI 3.158-7.961), lower education (high school vs ≥university, OR 1.599, 95% CI 1.044-2.448; middle school vs ≥university, OR 2.155, 95% CI 1.373-3.381; ≤elementary school vs ≥university, OR 3.889, 95% CI 2.475-6.109), BMI (18.5-25 kg/m2 vs ≥25 kg/m2, OR 1.646, 95% CI 1.169-2.318; <18.5 kg/m2 vs ≥25 kg/m2, OR 2.696, 95% CI 0.959-7.577), pulmonary tuberculosis (OR 3.515, 95% CI 1.735-7.122), current bronchial asthma (OR 8.374, 95% CI 3.588-19.544), smoking (former vs never, OR 1.643, 95% CI 1.087-2.484; current vs never, OR 1.605, 95% CI 1.058-2.436), CKD (<60 mL/min/1.73m2 vs ≥90 mL/min/1.73m2, OR 2.199, 95% CI 1.196-4.043; <90 mL/min/1.73m2 vs ≥90 mL/min/1.73m2, OR 0.899, 95% CI 0.637-1.240). Conclusion: In a Korean population ≥40 years old, the prevalence of participants with COPD was 17.4%. CKD was more prevalent in participants with COPD than those with NLF. Age over 70, male, a body mass index less than 25kg/m2, low level of education, pulmonary tuberculosis, current bronchial asthma, smoking, and CKD were associated with the development of COPD.
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