title: Bronchial asthma is associated with increased risk of chronic kidney disease.
abstract: BACKGROUND
  Bronchial asthma influences some chronic diseases such as coronary heart disease, diabetes mellitus, and hypertension, but the impact of asthma on vital diseases such as chronic kidney disease is not yet verified. This study aims to clarify the association between bronchial asthma and the risk of developing chronic kidney disease.
  
  
  METHODS
  The National Health Research Institute provided a database of one million random subjects for the study. A random sample of 141 064 patients aged ≥18 years without a history of kidney disease was obtained from the database. Among them, there were 35 086 with bronchial asthma and 105 258 without asthma matched for sex and age for a ration of 1:3. After adjusting for confounding risk factors, a Cox proportional hazards model was used to compare the risk of developing chronic kidney disease during a three-year follow-up period.
  
  
  RESULTS
  Of the subjects with asthma, 2 196 (6.26%) developed chronic kidney disease compared to 4 120 (3.91%) of the control subjects. Cox proportional hazards regression analysis revealed that subjects with asthma were more likely to develop chronic kidney disease (hazard ratio [HR]: 1.56; 95% CI: 1.48-1.64; p < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region, diabetes mellitus, hypertension, hyperlipidemia, and steroid use, the HR for asthma patients was 1.40 (95% CI: 1.33-1.48; p = 0.040). There was decreased HRs in steroid use (HR: 0.56; 95% CI: 0.62-0.61; p < 0.001) in the development of chronic kidney disease. Expectorants, bronchodilators, anti-muscarinic agents, airway smooth muscle relaxants, and leukotriene receptor antagonists may also be beneficial in attenuating the risk of chronic kidney disease.
  
  
  CONCLUSIONS
  Patients with bronchial asthma may have increased risk of developing chronic kidney disease. The use of steroids or non-steroidal drugs in the treatment of asthma may attenuate this risk.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Huang
authors.forename: Shinn-Ying
authors.initials: SY
authors.lastname: Ho
authors.forename: Chien-Hsun
authors.initials: CH
authors.lastname: Li
authors.forename: Fang-Ying
authors.initials: FY
authors.lastname: Chu
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Ciou
authors.forename: Hua-Chin
authors.initials: HC
authors.lastname: Lee
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, Tri-Service General Hospital, School of Medicine and Student Counseling Center, National Defense Medical Center, #325, Sec 2, Cheng-Gong RdNei- Hu District, Taipei City, Taiwan. pierrens@mail.ndmctsgh.edu.tw.
authors.forename: Nian-Sheng
authors.initials: NS
authors.lastname: Tzeng
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis
chemical_list: D000305:Adrenal Cortex Hormones