Background
Methods
Eligibility criteria
Search strategy
Selection process
Data abstraction
Data analysis
Results
Study | Population | COPD diagnosis method & Definition of CKD | Methodological features | Results |
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Baty et al.; 2013 [8] Study design: Population based case-control study Funding: Takeda Pharma AG, Switzerland | Setting & period: All hospitalizations in Switzerland between 2002 and 2010 COPD group: 340, 948 patients, 64% males, median age 73 years Non-COPD group: 340,948 patients, 64% males, median age 73 years | Diagnosis of COPD: Based on ICD-10 codes CKD definition: Based on ICD-10 code Blinding of outcome adjudicator: not reported | Selection bias: none Information bias: objective outcome evaluation: no; standardized CKD risk measurement: no Confounding: no Matching: yes. Adjustment in analysis: yes Confounding variables: no Loss to follow up: none | 4.39% of patients with COPD had Chronic kidney disease (ICD 10 code, N188) compared to 2.13% of patients without COPD (p < 0.001) 4.64% of patients with COPD had Chronic kidney disease unspecified (ICD 10 code, N189) compared to 2.25% of patients without COPD (p < 0.001) |
Gjerde et al.; 2011 [9] Study design: Case-control study Funding: The Foundation for Respiratory Research, Center for Clinical Research, Bergen | Setting & period: Patients aged 40-76 years with COPD were recruited from health institutions in Hordaland County in Western Norway, where as those without COPD were recruited among former participants from a general population survey in Hordaland County; between 2006 and 2007 COPD group: 433 patients, 59.6% male Non-COPD group: 233 patients | Diagnosis of COPD: using Spirometry CKD definition: eGFR <60 Blinding of outcome adjudicator: not reported | Selection bias: yes, voluntarily included, not random Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: yes Confounding: yes Matching: no. Adjustment in analysis: yes Confounding variables: no Loss to follow up: none | Prevalence of undiagnosed renal failure in the COPD patients was 6.9%, significantly higher than among the subjects without COPD (p < 0.001) |
Incalzi et al.; 2010 [10] Study design: Case-control study Funding: not reported | Setting & period: Participants aged 65 years and older were recruited from pulmonary medicine outpatient facilities in University of Palermo, Italy COPD group: 356 patients Non-COPD group: 290 patients | Diagnosis of COPD: Spirometry CKD definition: eGFR < 60 using MDRD equation Blinding of outcome adjudicator: not reported | Selection bias: no Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: yes Confounding: no Matching: yes (age) Adjustment in analysis: yes Confounding variables: no Loss to follow up: none | Overall prevalence of Chronic renal failure was 43.0% in COPD group and 23.4% in non-COPD group (p < 0.001) Logistic regression analysis revealed significant association between COPD and concealed chronic renal failure (OR: 2.19; CI: 1.17-4.12) and overt chronic renal failure (OR: 1.94; CI: 1.01-4.66) |
Joo et al.; 2012 [11] Study design: Cross-sectional Survey Funding: Grant of Korea Healthcare Technology R&D project | Setting & period: Database of the fourth Korean Health and Nutrition Examination Survey with a nationally representative sample, during 2008. Aged ≥ 40 years COPD group: 354 patients, 67.2% male, mean age 64.6 years Non-COPD group: 1823 patients, 36.9% male, mean age 54.4 years | Diagnosis of COPD: Spirometry, FEV1/FVC < 0.7 CKD definition: patients’ awareness of CKD diagnosis was surveyed Blinding of outcome adjudicator: not reported | Selection bias: no Information bias: objective outcome evaluation: yes, for COPD diagnosis only; standardized CKD risk measurement: no Confounding: yes Matching: no. Adjustment in analysis: yes Confounding variables: gender, mean age Loss to follow up: none | 0.6% of patients in COPD group had Chronic renal failure compared to 0.4% in non-COPD group (p = 0.41, not statistically significant) |
Mapel et al.; 2013 [12] Study design: retrospective case-control cohort analysis Funding: grant from Pfizer Pharmaceuticals Inc. | Setting & period: patients aged 40 years or older seen in 4 hospitals and a network of outpatient clinics of Lovelace Health Systems (LHS) in New Mexico, USA during the study period 2005-2008 COPD group: 2284 patients of LHS aged 40 or more with COPD and have at least 2 outpatient clinic visits or one hospitalization and enrolled with LHS for at least 12 months during the study period; 47.5% men; mean age 70.3 +/- 9.8 yrs Non-COPD group: 5959 randomly selected patients without a diagnosis of COPD and be of same age and gender | Diagnosis of COPD: ICD-9 diagnosis code of COPD CKD definition: ICD-9 codes and abnormal renal function tests Blinding of outcome adjudicator: not reported | Selection bias: none Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: yes Confounding: no Matching: yes (age, gender). Adjustment in analysis: yes Confounding variables: no Loss to follow up: none | Chronic renal failure was more than three times more prevalent among COPD patients (2.89%) than among controls (0.79%) (p < 0.001) |
Nagorni-Obradovic; 2014 [13] Study design: cross sectional study (case-control analysis) Funding: Ministry of Education and Science of the Republic of Serbia | Setting & period: 10,013 nationally representative sample of adults aged 40 years or older who participated in multipurpose health survey of population of Serbia in 2006 COPD group: 653 patients, 46.6% male, mean age 62.8 years (SD: 12.4) Non-COPD group: 9.360 patients, 54.4% male, mean age 59.3 years (SD: 12.2) | Diagnosis of COPD: Self-reported history of chronic bronchitis and emphysema CKD definition: Self-reported history of chronic renal disease Blinding of outcome adjudicator: N/A | Selection bias: no Information bias: objective outcome evaluation: no; standardized CKD risk measurement: no Confounding: no Matching: no Adjustment in analysis: yes (age, gender, educational level, smoking) Confounding variables: no Loss to follow up: n/a | 20.6% of COPD patients reported having a diagnosis of chronic renal failure compared to 9.3% of non-COPD patients (p < 0.01) |
Schnell et al., 2012 [14] Study design: cross-sectional study (case-control analysis) Funding: Johns Hopkins, NCRR and NIH | Setting & period: non-institutionalized civilians in the US aged 45 years or more who participated in the National Health and Nutrition Examination Survey (NHANES) from 1998 through 2008 COPD group: 995 patients, 39.9% males, mean age 62.7 years (CI: 61.7-63.8) Non-COPD group: 14,828 patients, 47% males, mean age 60 years (CI: 59.6-60.3) | Diagnosis of COPD: positive response in NHANES questions to either chronic bronchitis or emphysema with negative response to current asthma CKD definition: NHANES question with positive response to eGFR < 60 as calculated using MDRD equation Blinding of outcome adjudicator: N/A | Selection bias: no Information bias: objective outcome evaluation: no; standardized CKD risk measurement: yes Confounding: no Matching: no Adjustment in analysis: yes Confounding variables: none Loss to follow up: n/a | 16.2% of patients with physician diagnosed COPD reported having low eGFR, compared to 10.5% of patients without physician diagnosed COPD (p < 0.0001) |
Van Gestel et al.; 2009 [15] Study design: cohort study Funding: none | Setting & period: 3358 patients who underwent elective vascular surgery or lower limb arterial reconstruction surgeries between January 1990 to December 2006 COPD group: 1310 patients Non-COPD group: 2048 patients | Diagnosis of COPD: post bronchodilator pulmonary function test CKD definition: based on calculated eGFR <60 estimated using MDRD equation Blinding of outcome adjudicator: not reported | Selection bias: yes, convenience sample Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: yes Confounding: yes. Matching: No. Adjustment in analysis: yes Confounding variables: age, gender, type of surgery, current smoking, previous heart failure, hypertension, Diabetes, hyperlipidemia Loss to follow up: none | COPD was associated with a higher risk of prevalent CKD even after adjustment for confounding variables – OR: 1.22 (1.03 – 1.44) (p = 0.03) A borderline significant relationship was observed for mild COPD while moderate COPD was independently associated with CKD. No significant association was found between severe COPD and CKD |
Yoshizawa et al.; 2015 [6] Study design: retrospective case-control cohort analysis Funding: none | Setting & period: outpatient clinic visits of Kanamecho Hospital, Tokyo, Japan for the study period of May 2011 to April 2012 COPD group: 108 stable COPD patients; 83.3% males; mean age 74.3 ± 7.1 year. Non-COPD group: 73 patients of the same outpatient practice; 49.3% males; mean age 71.8 ± 7.3 years | Diagnosis of COPD: spirometry reading of FEV1/FVC less than 70% after inhalation of a bronchodilator, and severity of obstruction judged according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria CKD definition: eGFR less than 60 mL/min/1.73 m2 as per calculation based on serum Creatinine and serum Cystatin levels separately Blinding of outcome adjudicator: not reported | Selection bias: no Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: yes Confounding: yes. Matching: No. Adjustment in analysis: yes Confounding variables: age, gender, BMI, hypertension, Diabetes, hyperlipidemia Loss to follow up: none | Prevalence of CKD (using Se Cr for calculation of eGFR) was significantly higher in COPD group - OR: 4.91 (1.94 – 12.46) (p = 0.0004) Prevalence of CKD (using Se Cys for calculation of eGFR) was significantly higher in COPD group - OR: 6.30 (2.99 – 13.26) (p < 0.0001) |
Study | Population | COPD diagnosis method & Definition of CKD | Methodological features | Results |
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Almagro et al., 2002 [17] Study design: prospective cohort study Funding: not reported | Setting & period: patients hospitalized to an acute-care hospital in Barcelona (Spain) for acute exacerbation of COPD, between October 1996 and May 1997 Patient group: 135 patients, 96% male, median age 72.2 ± 9.25 years | Diagnosis of COPD: Spirometry CKD definition: not defined, diagnosis information obtained from Charlson index | Selection bias: yes, patients admitted with COPD exacerbation Information bias: Objective outcome evaluation: no; standardized CKD risk measurement: no | 4.4% of the patients are reported to have renal failure |
Almagro et al., 2009 [18] Study design: Cross-sectional, multi-center study Funding: | Setting & period: patients admitted with COPD exacerbation to any of the participating 26 hospital centers throughout Spain, consecutively between January 1, 2007 and December 31, 2008 Patient group: 398 patients, 89% male, mean age of 73.7 years | Diagnosis of COPD: Spirometry CKD definition: not defined, comorbidity information obtained from Charlson index and an ad hoc questionnaire | Selection bias: patients admitted with COPD exacerbation Information bias: Objective outcome evaluation: no; standardized CKD risk measurement: no | 6.5% of patients are reported to have moderate kidney failure |
Almagro et al.; 2012 [16] Study design: Longitudinal, observational, multi-center study Funding: provided by Chiesi España | Setting & period: Patients hospitalized for COPD exacerbation to 70 ED and internal medicine services in Spain between October 2009 and October 2010 Patient group: 606 patients, 89.9% male, median age 72.6 years (range, 41-94) | Diagnosis of COPD: Spirometry CKD definition: not defined, diagnosis information obtained using Charlson index and a questionnaire | Selection bias: yes, patients admitted with COPD exacerbation Information bias: Objective outcome evaluation: no; standardized CKD risk measurement: no | 15.5% of patients are reported to have Kidney disease with serum creatinine <3 0.7% of patients are reported to have Kidney disease with serum creatinine >3 |
Antonelli Incalzi et al., 1997 [19] Study design: Retrospective cohort study Funding: not reported | Setting & period: Consecutive patients discharged from Catholic University in Rome between the years 1980 and 1990, after an acute exacerbation of COPD Patient group: 270 patients, 83% male, mean age 67 ± 9 (SD) years | Diagnosis of COPD: Spirometry CKD definition: not defined, obtained from Charlson’s index | Selection bias: patients likely with severe COPD Information bias: Objective outcome evaluation: no; standardized CKD risk measurement: no | 6.6% of patients were noted to have chronic renal failure Death in these patients was predicted by several variables including chronic renal failure (HR 1.79; 95% CI 1.05–3.02) |
Chen et al.; 2016 [7] Study design: Case-Cohort study Funding: Ministry of Science of Technology, Taiwan | Setting & period: Patients aged 40 years or older who had inpatient hospitalization between 1998 and 2008 with Longitudinal Health Insurance Database (LHID) 2000 as the case group COPD group: 7,739 patients, 67.5% males, mean age 71.7 years Non-COPD group: 15,478 patients, 67.5% males, mean age 71.7 years | Diagnosis of COPD: Based on hospitalization for COPD CKD definition: Clinical diagnosis Blinding of outcome adjudicator: not reported | Selection bias: none Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: yes Confounding: no Matching: yes. Adjustment in analysis: yes Confounding variables: yes; age, gender, first diagnosis of COPD Loss to follow up: none | Overall incidence of CKD was higher in COPD group than in non-COPD group. The adjusted hazard ratio of case was 1.61 (P <0.0001) times that of control. |
Ford, E S.; 2015 [20] Study design: retrospective case-control study Funding: None | Setting & period: 5711 American men and women aged 40 to 79 years who participated in the Third National Health and Nutrition Examination Survey (NHANES III) during the term 1988 through 1994 and followed through 2006 COPD group: 1390 participants Non-COPD group: 4321 participants | Diagnosis of COPD: spirometry CKD definition: eGFR calculation using the Chronic Kidney Disease Epidemiology Collaboration equations Blinding of outcome adjudicator: not reported | Selection bias: no Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: yes Confounding: no Matching: yes. Adjustment in analysis: yes Confounding variables: no Loss to follow up: none | The rates of incidence or prevalence of CKD was not reported. Comparative data on mean eGFR values in COPD group and Non-COPD group was reported. Adjusted mean levels of eGFR were significantly lower in adults with moderate-severe COPD (87.7 mL/min/1.73 m2) than in adults with normal lung function (89.6 mL/min/1.73 m2) (p = 0.015) |
García-Olmos et al., 2013 [21] Study design: Observational, cross-sectional study Funding: CDTI/Ministry of Science and Innovation | Setting & period: practice population allocated to 129 Family Physicians, conducted in a health area of the Madrid Patient group: 3,183 patients, 76% male, mean age of 71.41 ± 11.50 years | Diagnosis of COPD: from clinical history in EMR CKD definition: not defined, obtained from EMR | Selection bias: not validated COPD diagnostic method Information bias: Objective outcome evaluation: no; standardized CKD risk measurement: no | 6.34% of patients have chronic renal failure |
Marti et al., 2005 [22] Study design: Retrospective cohort study Funding: In part by grant from Fundacio ‘noma’Catalana de Pneumologia and by Red Respira-ISCIII-RTIC-03/11 | Setting & period: patients with COPD initiating LTOT >15 h/day during 1992–1999 in a tertiary teaching hospital (Vall d’Hebron Hospital, Barcelona, Spain) Patient group: 128 patients, 98.4% male, mean age ± SD 68.9 ± 9.7 years | Diagnosis of COPD: PFTs CKD definition: not defined, assessed using Charlson index | Selection bias: yes, COPD patients only on long term O2 therapy Information bias: Objective outcome evaluation: no; standardized CKD risk measurement: no | 1.6% of patients are reported to have renal disease |
Terzano et al., 2010 [23] Study design: Prospective longitudinal study Funding: | Setting & period: Consecutive COPD patients admitted to four hospitals in Italy for acute exacerbation from 1999 to 2000, and followed up until December 2007 Patient group: 288 patients, 78.8% male, mean age 69.2 years (SD ± 6.4) | Diagnosis of COPD: standardized CKD definition: not defined, assessed using Charlson index | Selection bias: yes, patients admitted for acute exacerbation Information bias: Objective outcome evaluation: no; standardized CKD risk measurement: no | 26.3% of patients are reported to have chronic renal failure |
Van Manen et al.; 2001 [24] Study design: case control study Funding: Boehringer Ingelheim NL supplied materials and personnel for performing lung function testing | Setting & period: Adults aged 40 years or more who visited outpatient practices in urban and suburban regions of western part of Netherlands from October 1996 through June 1997 COPD group: 290 patients (male 64.1%; mean age 65.8 years) Non-COPD group: 421 patients (male 41.1%; mean age 65.9 years) | Diagnosis of COPD: Pulmonary function tests CKD definition: not reported Blinding of outcome adjudicator: not reported | Selection bias: no Information bias: objective outcome evaluation: yes; standardized CKD risk measurement: no Confounding: no Matching: no Adjustment in analysis: yes Confounding variables: no Loss to follow up: none | The study population was surveyed to estimate the prevalence of a set of 23 diseases in patients with COPD compared to patients without COPD. Self-reported renal disease was included in general and no specifications on chronic kidney disease or renal failure was surveyed. Renal disease was reported 0.3% in patients with COPD compared to 0.2% in non-COPD patients |