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

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    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.
    Issue Date
    2012-09-07
    
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    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
    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
    ae974a485f413a2113503eed53cd6c53
    10.1159/000342207
    Scopus Count
    Collections
    Letterkenny University Hospital

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