Source: Annual Congress 2009 - Prognosis and comorbidities in COPD
Disease area: Airway diseases

Abstract

Background: Patients with COPD frequently have a reduced muscular mass. Thus, serum creatinine might be falsely low also in the presence of depressed glomerular filtration rate (GFR).
Objective: To investigate the prevalence and correlates of concealed CRF, i. e. reduced GFR despite normal serum creatinine, in elderly COPD patients.
Methods: We evaluated 356 COPD outpatients aged 65 years or more consecutively recruited in 15 centers participating in the Extrapulmonary Consequences of COPD in the Elderly (ECCE) Study, a multicenter observational study. GFR was estimated using the Modification of Diet in Renal Disease study equation. Patients were categorized as having normal renal function (GFR≥60 ml/min/1.73 m²), concealed (creatinine<1.3 mg/dl and reduced GFR) or overt (creatinine≥1.3 mg/dl and reduced GFR) CRF. Independent correlates of concealed CRF were investigated by logistic regression analysis.
Results. The prevalence of concealed CRF was 19.9%. Age (for 1 year , OR: 1.06; 95%CI: 1.0-1.14), hypoalbuminemia (OR: 4.08; 95%CI: 1.57-10.6) and muscle-skeletal diseases (OR: 2.8; 95%CI: 1.27-6.49) were independent positive correlates of concealed CRF, while male gender (OR: 0.29; 95%CI: 0.13-0.65) and PaCO₂ (for each 1 mm Hg increase, OR: 0.93; 95%CI: 0.88-0.99) qualified as negative correlates of the outcome.
Conclusions. Concealed CRF is highly prevalent in COPD patients, and is associated with age and markers of protein depletion and muscle wasting. The inverse relationship between prevalence of concealed CRF and PaCO₂ is difficult to interpret. Concealed CRF should be suspected and screened mainly in elderly and malnourished COPD patients.

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M. E. Conte, A. Corsonello, C. Pedone, S. Scarlata, G. Paglino, S. Battaglia, V. Bellia, R. Antonelli Incalzi (Rome, Cosenza, Palermo, Taranto, Italy). Concealed renal failure in COPD. The extrapulmonary consequences of COPD in the elderly (ECCE) study. Eur Respir J 2009; 34: Suppl. 53, 508

Member's Comments

- 22.10.2011 09:27
its good presentation and i want to know more about concealed renal failure.

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