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Lung Function and Incident Kidney Disease: The Atherosclerosis Risk in Communities (ARIC) Study.

TitleLung Function and Incident Kidney Disease: The Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsSumida K, Kwak L, Grams ME, Yamagata K, Punjabi NM, Kovesdy CP, Coresh JJ
Secondary AuthorsMatsushita K
JournalAm J Kidney Dis
Volume70
Issue5
Pagination675-685
Date Published2017 Nov
ISSN1523-6838
KeywordsAfrican Americans, Cohort Studies, European Continental Ancestry Group, Female, Forced Expiratory Volume, Glomerular Filtration Rate, Humans, Incidence, Kidney Failure, Chronic, Lung, Lung Diseases, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Renal Dialysis, Renal Insufficiency, Chronic, Spirometry, United States, Vital Capacity
Abstract

BACKGROUND: Reduced lung function is associated with clinical outcomes such as cardiovascular disease. However, little is known about its association with incident end-stage renal disease (ESRD) and chronic kidney disease (CKD).

STUDY DESIGN: Prospective cohort study.

SETTING & PARTICIPANTS: 14,946 participants aged 45 to 64 years at baseline (1987-1989) in the Atherosclerosis Risk in Communities (ARIC) Study (45.0% men and 25.2% black), with follow-up through 2012.

PREDICTORS: Race- and sex-specific quartiles of percent-predicted forced vital capacity (FVC) and the proportion of forced expiratory volume in 1 second of expiration to FVC (FEV/FVC) at baseline determined with spirometry.

OUTCOMES: Incident ESRD (defined here as renal replacement therapy or death due to CKD) as the primary outcome and incident CKD (defined here as ESRD, ≥25% decline in estimated glomerular filtration rate to a level 

RESULTS: During a median follow-up of 23.6 years, 526 (3.5%) participants developed ESRD. After adjusting for potential confounders, the cause-specific HR of incident ESRD for the lowest (vs highest) quartile was 1.72 (95% CI, 1.31-2.26) for percent-predicted FVC and 1.33 (95% CI, 1.03-1.73) for FEV/FVC. Compared to a high-normal lung function pattern, a mixed pattern (ie, percent-predicted FVC

LIMITATIONS: Limited number of participants with moderate/severe lung dysfunction and spirometry only at baseline.

CONCLUSIONS: Reduced lung function, particularly lower percent-predicted FVC, is independently associated with CKD progression. Our findings suggest a potential pathophysiologic contribution of reduced lung function to the development of CKD and a need for monitoring kidney function in persons with reduced lung function.

DOI10.1053/j.ajkd.2017.05.021
Alternate JournalAm J Kidney Dis
PubMed ID28754455
PubMed Central IDPMC5651181
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States