The Impact of Chronic Obstructive Pulmonary Disease and Smoking on Mortality and Kidney Transplantation in End-Stage Kidney Disease.

2.50
Hdl Handle:
http://hdl.handle.net/10147/246274
Title:
The Impact of Chronic Obstructive Pulmonary Disease and Smoking on Mortality and Kidney Transplantation in End-Stage Kidney Disease.
Authors:
Kent, Brian D; Eltayeb, Elhadi E; Woodman, Alastair; Mutwali, Arif; Nguyen, Hoang T; Stack, Austin G
Affiliation:
Regional Kidney Centre, Letterkenny General Hospital, Health Services Executive-West, Donegal, Ireland.
Citation:
The Impact of Chronic Obstructive Pulmonary Disease and Smoking on Mortality and Kidney Transplantation in End-Stage Kidney Disease. 2012, 36 (3):287-295 Am. J. Nephrol.
Journal:
American journal of nephrology
Issue Date:
7-Sep-2012
URI:
http://hdl.handle.net/10147/246274
DOI:
10.1159/000342207
PubMed ID:
22965176
Abstract:
Background: Chronic obstructive pulmonary disease (COPD) and tobacco use are leading causes of morbidity and mortality. The prevalence and clinical impact of COPD on mortality and kidney transplantation among patients who begin dialysis therapy is unclear. Methods: We explored the clinical impact of COPD and continued tobacco use on overall mortality and kidney transplantation in a national cohort study of US dialysis patients. National data on all dialysis patients (n = 769,984), incident between May 1995 and December 2004 and followed until October 31, 2006, were analyzed from the United States Renal Data System. Prevalence and period trends were determined while multivariable Cox regression evaluated relative hazard ratios (RR) for death and kidney transplantation. Results: The prevalence of COPD was 7.5% overall and increased from 6.7 to 8.1% from 1995-2004. COPD correlated significantly with older age, cardiovascular conditions, cancer, malnutrition, poor functional status, and tobacco use. Adjusted mortality risks were significantly higher for patients with COPD (RR = 1.20, 95% CI 1.18-1.21), especially among current smokers (RR = 1.28, 95% CI 1.25-1.32), and varied inversely with advancing age. In contrast, the adjusted risks of kidney transplantation were significantly lower for patients with COPD (RR = 0.47, 95% CI 0.41-0.54, for smokers and RR = 0.54, 95% CI 0.50-0.58, for non-smokers) than without COPD [RR = 0.72, 95% CI 0.70-0.75, for smokers and RR = 1.00 for non-smokers (referent category)]. Conclusions: Patients with COPD who begin dialysis therapy in the US experience higher mortality and lower rates of kidney transplantation, outcomes that are far worse among current smokers.
Item Type:
Article
Language:
en
ISSN:
1421-9670

Full metadata record

DC FieldValue Language
dc.contributor.authorKent, Brian Den_GB
dc.contributor.authorEltayeb, Elhadi Een_GB
dc.contributor.authorWoodman, Alastairen_GB
dc.contributor.authorMutwali, Arifen_GB
dc.contributor.authorNguyen, Hoang Ten_GB
dc.contributor.authorStack, Austin Gen_GB
dc.date.accessioned2012-09-28T15:32:08Z-
dc.date.available2012-09-28T15:32:08Z-
dc.date.issued2012-09-07-
dc.identifier.citationThe Impact of Chronic Obstructive Pulmonary Disease and Smoking on Mortality and Kidney Transplantation in End-Stage Kidney Disease. 2012, 36 (3):287-295 Am. J. Nephrol.en_GB
dc.identifier.issn1421-9670-
dc.identifier.pmid22965176-
dc.identifier.doi10.1159/000342207-
dc.identifier.urihttp://hdl.handle.net/10147/246274-
dc.description.abstractBackground: Chronic obstructive pulmonary disease (COPD) and tobacco use are leading causes of morbidity and mortality. The prevalence and clinical impact of COPD on mortality and kidney transplantation among patients who begin dialysis therapy is unclear. Methods: We explored the clinical impact of COPD and continued tobacco use on overall mortality and kidney transplantation in a national cohort study of US dialysis patients. National data on all dialysis patients (n = 769,984), incident between May 1995 and December 2004 and followed until October 31, 2006, were analyzed from the United States Renal Data System. Prevalence and period trends were determined while multivariable Cox regression evaluated relative hazard ratios (RR) for death and kidney transplantation. Results: The prevalence of COPD was 7.5% overall and increased from 6.7 to 8.1% from 1995-2004. COPD correlated significantly with older age, cardiovascular conditions, cancer, malnutrition, poor functional status, and tobacco use. Adjusted mortality risks were significantly higher for patients with COPD (RR = 1.20, 95% CI 1.18-1.21), especially among current smokers (RR = 1.28, 95% CI 1.25-1.32), and varied inversely with advancing age. In contrast, the adjusted risks of kidney transplantation were significantly lower for patients with COPD (RR = 0.47, 95% CI 0.41-0.54, for smokers and RR = 0.54, 95% CI 0.50-0.58, for non-smokers) than without COPD [RR = 0.72, 95% CI 0.70-0.75, for smokers and RR = 1.00 for non-smokers (referent category)]. Conclusions: Patients with COPD who begin dialysis therapy in the US experience higher mortality and lower rates of kidney transplantation, outcomes that are far worse among current smokers.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to American journal of nephrologyen_GB
dc.titleThe Impact of Chronic Obstructive Pulmonary Disease and Smoking on Mortality and Kidney Transplantation in End-Stage Kidney Disease.en_GB
dc.typeArticleen
dc.contributor.departmentRegional Kidney Centre, Letterkenny General Hospital, Health Services Executive-West, Donegal, Ireland.en_GB
dc.identifier.journalAmerican journal of nephrologyen_GB
dc.description.provinceUlsteren

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