Title: Kidney Dysfunction, as a Manifestation of Systemic Effects of Chronic Obstructive Lung Disease

Biography:

Kinvanlun Ibragim Gadirovich  - Born in 1991. In 2015, he graduated from the Medical University, specializing in medical business. In 2017, he completed a traineeship with the status of a cardiologist.  At present, he is  graduate student 3 years of study is  and a responsible person for the development of scientific research at the Department of Therapy 2. Medical work is based in the Department of Nephrology at the Institute of Cardiology named after Academician Mirsaid Mirrahimov. He is also a member of the Society of Chronic Kidney Disease in Kyrgyzstan. During the time of scientific activity, 9 articles were published and participated in a republican conference.

 

Abstract

Abstract .  At present, COPD is considered as a disease with a systemic manifestation [1,2]. One of the most important extrapulmonary effects of COPD is renal dysfunction [3], which exacerbates the general background of the course and prognosis of the disease.                  

Purpose. To study risk factors, as well as the contribution of systemic effects of chronic obstructive pulmonary disease to the development of renal pathology.                           

 Materials and methods. We studied 121 patients with stage I – IV COPD among a man (n = 74) and a woman (n = 47), the average age was 58.5 years. All subjects were divided into 4 clinical and control groups. The concentration level of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF alpha) was determined. Statistically significant results were considered level p <0.05.    Results. In patients with COPD, 3 or more risk factors for the development of CKD have been identified. It was found that as the level of forced expiratory volume per second (FEV1) decreases, the average values of mycroalbuminuria (MAU) and cystatin C increase (table 1). The total frequency of cases of chronic kidney disease CKD (S1) at all stages of COPD in determining GFR by creatinine was 41.6%, S2–57.2%, S3 - 0.41%. When determining GFR using cystatin C, the frequency of stage S1 of CKD was 17.7%, S2 - 43.7%, S3 - 36.4% and S4 - 1.04%.

Table 1.

The results of the laboratory-anamnestic indicators of patients,

suffering from COPD (x ± m)

Indicator	COPD stages
	I	II	III	IV	the control
Age, years	50,38±7,96	53±11,4	63±10,57	61,26±9,8	39,94±10,9
M/F	1811	1611	2113	1912	9/8
BMI, kg/м2	26,06±2,67	28,9±11,6	28,57±5,02	25,67±5,04	23,9±3,27
Smoking, %	28,5	42,1	35	65	0
Hyperlipidemia,  %	33	42,1	55,8	30	0
Hyperuricemia,%	33	57,9	47	55	0
Proteinuria,%	0	0	8	10	0
MAU, mg/l	27,5±10,5	25±7,07	43,57±21,3	68±31,61	8,82±4,15
Creatinine, μmol / l	61,44±8,37	73,6±17,2	80,4±16,6	83,94±15,7	65±13,4
Cystatin C mg / L	0,93±0,05	1,09±0,16	1,11±0,3	1,31±0,374	0,85±0,1
GFR creatinine ml / min	103,7±9,31	89,4±21,6	81,15±18,1	81,4±17,8	110,5±13,8
GFR cystatin C, ml / min	86,58±10,4	70,6±19	69,24±21,4	57,6±17,53	102,7±13,2
TNF alpha	1,93+ 1,19*	3,93+ 4,79	2,39+ 2,54	4,13±1,87*	1,23±1,60
IL-6	1,097+ 1,08	1,29+ 0,82	5,01±4,05*	13,39±9,9*	0,934±0,81
CRP	1,58±1,10	1,97±1,4	4,31±1,5*	4,32±1,6*	1,279±0,80

Note: * - p <0.05 Between the COPD stage and the control group. M – men; F - women; BMI - body mass index. GFR - glomerular filtration rate.

Serum levels of IL-6, TNF alpha, C-reactive protein (CRP) tended to increase with increasing severity of COPD. The correlation analysis revealed a positive relationship between the level of cystatin C and IL-6, CRP, and the MAU indicator positively correlated with IL-6, TNF alpha.

Output. Thus, a patient with COPD has many risk factors for developing renal dysfunction; systemic inflammation in COPD makes a major contribution to the formation of renal dysfunction.