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Acute kidney injury increases mortality risk among patients with COPD

Patients with chronic obstructive pulmonary disease plus acute kidney injury demonstrated an increased mortality risk compared with those who had COPD alone, according to study results.

“Acute kidney injury is considered a predictor of poor outcome in patients with COPD exacerbation,” M.F. Bakarat, of the faculty of epidemiology and population health at London School of Hygiene and Tropical Medicine, and colleagues wrote. “Consequently, it is recommended for patients suffering from simultaneous acute kidney injury and COPD exacerbation to be identified as higher risk patients and, hence, monitored more closely, especially early after hospital discharge.”

Bakarat and colleagues evaluated 189,561 patients with COPD from the Clinical Practice Research Datalink to determine the mortality risk among those hospitalized due to an acute kidney injury. Of these patients, 36,107 patients reported at least one exacerbation at subsequent follow-ups.

Incidence of acute kidney injury in the COPD cohort was 128 per 100,000 person-years, and 1.9% of patients experienced acute kidney injury at the time of exacerbation.

Bakarat and colleagues noted the mortality rate for patients with acute kidney injury at the time of exacerbation was 521 per 1,000 person-years. Factors such as male sex, lower glomerular rate and older age were associated with an increased likelihood of acute kidney injury or mortality.

Compared with patients without acute kidney injury, those with COPD and an acute kidney injury had a 1.8-fold increased adjusted mortality risk within the first 6 months after an exacerbation event (95% CI, 1.61-2.03). – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.