Association Between Decreased Renal Function and Pulmonary Function Decline in Community-dwelling Adults.

Abstract

Emerging evidence suggests that there is a close relationship between the human lung and kidney. This study evaluated whether decreased renal function was associated with accelerated pulmonary function decline in a large-scale community-based cohort. A total of 10,028 subjects of the prospective Ansung-Ansan cohort were eligible for the longitudinal analysis of changes in pulmonary function associated with decreased renal function (glomerular filtration rate <60 ml/min/1.73 m2). Logistic regression analysis was performed to evaluate factors associated with decreased baseline renal function, and a linear mixed model compared changes in pulmonary function in participants with and without decreased renal function after propensity score matching (PSM). At baseline, subjects with and without decreased renal function showed distinct characteristics, and the factors associated with decreased renal function were age, baseline forced vital capacity, hypertension, and white blood cell (WBC) count. A 1:4 PSM of age, sex, body mass index, and smoking status showed that the proportion of those with hypertension and the WBC count differed between the patients with decreased and normal renal function. In the PSM population, those with decreased renal function had a greater decline in forced expiratory volume in the first second (FEV1) than those without (p=0.0402); however, these differences were not found to be evident when hypertension and WBC count were further matched (p=0.0807). The results of our study demonstrated that decreased renal function was not directly associated with the rapid decline in pulmonary function in a community-based general population setting.