Risk factors of renal insufficiency in patients with chronic obstructive pulmonary disease; A systematic review and meta-analysis

Abstract

Abstract Background Chronic obstructive pulmonary disease (COPD) is a progressive, systematic inflammatory disorder. Chronic kidney disease (CKD) is frequently associated with COPD. A number of risk factors of CKD have been investigated among patients living with COPD. Conversely, the findings of the previous studies are contradictory and inconsistent. The present systematic review and meta-analysis revealed the risk of chronic renal insufficiency among patients living with COPD and patients-related and management-related risk factors. Methods Literature searching of twelve databases was performed on 14 July 2023. All clinical studies comparing the patients-related, COPD-related, and management-related variables among patients with COPD who developed chronic renal insufficiency and control groups were eligible. Studies reported the potential predictors of chronic renal insufficiency among patients with COPD were included. Results This meta-analysis included nine studies, encompassing 64289 patients with COPD. Of them, 10217 patients developed CKD, while 54072 had no-CKD. The risk of CKD after COPD was 22.5% (event rate 0.225, 95%CI; 17.2, 0.289; p < 0.001). Elderly patients (MD;5.50 years ,95%CI; 2.99, 8.02; p < 0.001), hypertensive patients (RR; 1.47, 95%CI; 1.16, 1.85; P = 0.001), diabetic patients (RR; 2.27, 95%CI; 1.52 to 3.38; P < 0.001), and patients with peripheral vascular disease (RR; 1.52, 95%CI; 1.45, 1.6; P < 0.001) were at higher risk of CKD. Conclusions The present meta-analysis pointed out the considerable risk of CKD among patients with COPD. Elderly patients with hypertension, diabetes mellitus, stroke, or peripheral vascular diseases were at higher risk of CKD.