title: Prevalence of chronic kidney disease in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.
abstract: The incidence and prevalence of chronic kidney disease (CKD) continue to rise worldwide. Increasing age, diabetes, hypertension, and cigarette smoking are well-recognized risk factors for CKD. Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation leading to airway obstruction and parenchymal lung destruction. Due to some of the common pathogenic mechanisms, COPD has been associated with increased prevalence of CKD.
  
  
  
  Systematic review of medical literature reporting the incidence and prevalence of CKD in patients with COPD using the Cochrane Collaboration Methodology, and conduct meta-analysis to study the cumulative effect of the eligible studies. We searched Medline via Ovid, PubMed, EMBASE and ISI Web of Science databases from 1950 through May, 2016. We included prospective and retrospective observational studies that reported the prevalence of CKD in patients with COPD.
  
  
  
  Our search resulted in 19 eligible studies of which 9 have been included in the meta-analysis. The definition of CKD was uniform across all the studies included in analysis. COPD was found to be associated with CKD in the included epidemiological studies conducted in many countries. Our meta-analysis showed that COPD was found to be associated with a significantly increased prevalence of CKD (Odds Ratio [OR] = 2.20; 95% Confidence Interval [CI] 1.83, 2.65).
  
  
  
  Studies included are observational studies. However, given the nature of our research question there is no possibility to perform a randomized control trial.
  
  
  
  Patients with COPD have increased odds of developing CKD. Future research should investigate the pathophysiological mechanism behind this association, which may lead to better outcomes.
authors.affiliation: Division of Nephrology at VAMC, Buffalo, NY, USA. Swarnasameer@gmail.com.|Department of Medicine, SUNY, Buffalo, NY, USA. Swarnasameer@gmail.com.
authors.forename: Swarna
authors.identifier: 0000-0002-4454-4857
authors.initials: S
authors.lastname: Gaddam
authors.affiliation: Department of Medicine, SUNY, Buffalo, NY, USA.
authors.forename: Sameer K
authors.initials: SK
authors.lastname: Gunukula
authors.affiliation: Division of Nephrology at VAMC, Buffalo, NY, USA.|Department of Medicine, SUNY, Buffalo, NY, USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Lohr
authors.affiliation: Division of Nephrology at VAMC, Richmond, VA, USA.|Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Arora
mesh_terms: D006801:Humans; D015994:Incidence; D016017:Odds Ratio; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012307:Risk Factors
keywords: Chronic bronchitis; Chronic kidney disease; Chronic obstructive pulmonary disease; Comorbidity; Emphysema; Glomerular filtration rate