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THE ROLE OF ALTERNATIVE MARKERS IN THE DIAGNOSIS OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Elena Bolotova, Anna Dudnikova

Abstract

Introduction: It is considered that the main comorbid diseases in chronic obstructive pulmonary disease (COPD) are cardiovascular disease, osteoporosis, anxiety and depressive illness. However, there are few reports of chronic kidney disease (CKD) as a comorbidity of COPD.

Materials and methods: The study included 198 patients with a diagnosis of COPD. The patients were divided into four groups according to the degree of COPD severity. In all the patients, calculation of glomerular filtration rate (GFR) based on formulas of СКD-EPI with serum creatinine and serum cystatin C was performed.

Results: GFR calculation by creatinine showed that the frequency of individuals with normal GFR>90 mL/min/1.73 m2 was significantly higher than than that of cystatin C (48% versus 12.6%, χ2=52.97, p<0.05). For the group of patients with decreased GFR in the range of 59-45 mL/min/1.73 m2, there were opposite results: the frequency of patients with calculation of GFR by cystatin C (34.3% versus 1%, χ2=48.87, p<0.05) was significantly higher. Similar data were obtained comparing the methods in groups with GFR of 44-30 mL/min/1.73 m2 (12.1% versus 0%, χ2=28.97, p<0.05) and GFR of 29-15 mL/min/1.73 m2 (5,0 versus 0%, χ2=5.13, p<0.05). In the interval from the reduced GFR of 89-60 mL/min/1.73 m2 there was no significant difference between these methods used (51% versus 35.8%, χ2=2.95, p>0.05).

Conclusion: Systemic effects of COPD induce the development of protein-energy malnutrition and muscle loss. A close relationship between creatinine and muscle tissue condition lowers the creatinine level and results in overestimation of the real GFR and underdiagnosis of CKD in these patients.


Keywords

CKD, COPD, creatinine, muscle dysfunction, cystatin C

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DOI: http://dx.doi.org/10.14748/ssm.v49i4.4017

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About The Authors

Elena Bolotova
"Kuban State Medical University" of the Ministry of Healthcare of the Russian Federation

Department of therapy –1, State Budgetary educational institution of higher professional education

Anna Dudnikova
Regional clinical hospital –2
Russian Federation

doctor

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