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How Does Copd Affect The Kidneys

Vaccines Kidney Disease & Covid

Keeping Kidneys Safe – Know How Medicines Affect the Kidneys

Vaccines are one of the most effective tools to protect your health and prevent disease. Vaccines work with your bodys natural defenses so your body will be ready to fight the virus if you are exposed .

While the effectiveness rates of COVID-19 vaccines are very good, we now know that people who are on immunosuppression medications for the treatment of advanced kidney disease and kidney transplant recipients, may not receive the same level of protection, also known as antibody immunity, from the COVID-19 vaccine as people who are not on immunosuppressive medication.

While more research is needed to learn more about the effectiveness in people with advanced CKD, those on dialysis, and transplant recipients — these vaccines have been demonstrated to be safe in this population.

The National Kidney Foundation urges patients with advanced kidney disease, including transplant and dialysis patients and patients requiring immunosuppression for treatment of advanced kidney disease, to continue masking and practicing social distancing, after being fully vaccinated.

Many experts also think getting a COVID-19 vaccine may help keep you from getting seriously ill if you do get COVID-19. These vaccines cannot give you COVID-19.

What Happens When Copd Causes Insufficient Oxygen In Your Kidneys

When your kidneys do not get the oxygen they need, they cannot function properly, which causes renal failure. This can cause a variety of problems, which can include:

  • Anemia
  • Inability to regulate salt and acid balance
  • Inability to filter blood properly
  • Death, if not treated properly

Patients with COPD who are still not getting the oxygen they need could experience reduced kidney function. People with COPD as well as other conditions that impair kidney function, like diabetes, may be more prone to kidney problems. If you have COPD, how can you preserve healthy kidney function?

Stage : Moderate Copd

At stage 2 of the disease, COPD symptoms become more pronounced and new symptoms may appear. This is the stage that many people start to notice their breathing difficulties and decide to seek help from a doctor.

At this point, lung function has declined further than stage 1, and the signs of COPD are more obvious. At this point, patients might be prescribed longer-lasting medications to deal with chronic symptoms and might be referred to a COPD support program to better learn how to manage their disease.

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Rehabilitation For Your Lungs

Inhaled drugs that relax the muscles around the airways, known as bronchodilators, are a mainstay of COPD therapy. Also, just as people with heart disease can benefit from cardiac rehabilitation, people with symptoms of COPD may benefit from pulmonary rehabilitation. The multifaceted program of aerobic exercise, strength training, and education helps patients manage their breathlessness and do everyday activities more easily.

How Oxygen Therapy Treats Your Copd And Kidneys

Advanced Copd Definition

Oxygen therapy is one of the main treatments for COPD, but did you know that it could also help minimize kidney problems in patients with COPD? Studies show that oxygen therapy improves kidney function in patients with COPD, so you could be treating two problems with one solution.

Oxygen therapy helps improve your oxygen intake and absorption by providing a higher concentration of pure oxygen to you via mask or nasal cannula. The air we breathe contains approximately 21% oxygen, so a higher concentration can be extremely beneficial for people whose lungs do not work as effectively. Additionally, if your lungs have trouble absorbing the oxygen, as is often the case with COPD, providing a higher concentration via supplemental oxygen makes it more likely that your organs, like your kidneys, will receive the amount of oxygen they need to function properly. Ask your doctor if oxygen therapy could help treat your COPD and kidneys.

Sometimes when patients are prescribed oxygen, they worry that they will be unable to continue living a rich and active life. While some oxygen delivery systems do make your daily activities more difficult, portable oxygen concentrators actually allow you to live your life as normally as possible, while getting oxygen treatments on the go.

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Emergency Use Authorization Updates

In the near future, the goal is for people age 12 and younger to be able to easily receive a COVID-19 vaccination as soon as possible. The Pfizer-BioNTech vaccine has already received EUA for adolescents between the ages of 12 and 16. The COVID-19 vaccine from Moderna has has received EUA for use in people age 18 and over, is currently enrolling adolescents ages 12 to 17 in clinical trials.

Hypercoagulability And Thrombosis In Covid

Recently, anti-phospholipid antibodies and infarcts in multiple vascular territories have been reported in three COVID-19 patients with thrombocytopenia. It is known that these antibodies can increase during several infections, and critical illness and may lead to thrombotic events .

Based on this data, a prophylactic dose of low molecular weight heparin has been advised to hospitalized COVID-19 patients, despite abnormal coagulation tests, and the thrombotic risk associated with prolonged bed resting .

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Respiratory Infections In Hemodialysis

Chronic kidney disease and end-stage renal disease increase the risk of bacterial infections, particularly urinary tract infections, pneumonia, and sepsis . This risk is partially due to dialysis access devices, but patients requiring renal replacement therapy are also susceptible to non-access-related infections. Many of these patients also have diabetes, take immunosuppressant agents and chronically retain uremic toxins. It follows that particular attention should be paid to the diagnosis and treatment of these infections. Choosing appropriate antibiotics class and dosage is crucial and nephrotoxic drugs should be avoided, if possible, in patients with residual renal function.

Pneumonia are the second more common cause of severe infections among subjects undergoing hemodialysis . They are most frequently community-acquired pneumonia, mainly caused by Streptococcus pneumoniae and seasonal influenza. Treatment of pneumonia in hemodialysis patients does not differ from the one for the general population, but the death rates are 1416 times higher . A polysaccharide vaccine against Streptococcus pneumonia is available with a satisfactory early serological response in these particular subjects. However, studies with over 6 months of observation showed a more rapid decline in antibody titer compared to the general population . Vaccination of all patients with ESRD and re-vaccination after 5 years is usually recommended.

Symptoms Of Heart Disease

Chronic Obstructive Pulmonary Disease Overview (types, pathology, treatment)

Heart disease often does not have any symptoms until your heart and blood vessels are badly damaged. If you have CKD, you and your doctor can watch closely for any signs of heart disease though blood work or monitoring how you feel. Symptoms of heart disease depend on the type of heart disease you have. Some symptoms to look out for are:

  • Chest pain
  • Pain, numbness, weakness or coldness in your legs or arms
  • Pain in the neck, jaw, throat, upper abdomen or back
  • Swelling of the legs, ankles and feet
  • Irregular heartbeats that feel rapid, pounding or fluttering
  • Dizziness, lightheadedness and fainting

Heart disease is easier to treat when caught early, so be sure to tell your doctor if you ever feel symptoms or have concerns about your risk.

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Stage : Very Severe Copd

Getting a stage 4 COPD diagnosis can be terrifying, to say the least. But even though it’s sometimes referred to as end stage COPD, it is not the end of your life and it is not a death sentence.

At this stage, lung function has declined to about 30% or less of normal . However, the severity of symptoms and how much they interfere with daily activities can vary greatly from person to person.

Your quality of life at stage 4 depends largely on healthy lifestyle choices and having an effective, tailored treatment plan that includes medication and supplemental oxygen. Far from defeated by their disease, many people with stage 4 COPD live happy, active lives for many years.

As your symptoms worsen and become more difficult to manage at this stage of the disease, you will need to be more vigilant than ever at adhering to your treatment plan and adjusting it when symptoms change or worsen. That means carefully tracking symptoms with your doctor, taking medication on time, and sticking with your healthy diet and regular exercise routine.

Measurements Of Symptoms Functional Status Exercise Capacity And Health Status

Severity of dyspnoea was assessed using the modified British Medical Research Council dyspnoea scale . The COPD related symptom load was assessed by the COPD Assessment Test . Functional status and exercise capacity were assessed by the timed up and go and the six-minute walk test . The timed up and go measures the time taken for the patient to rise from a chair, walk 3m, turn, walk back, and sit down again . The six-minute walk test was performed as described in the former American Thoracic Society guidelines . COPD specific health status was measured by the St Georges Respiratory Questionnaire . Quality of life was measured by the EuroQoL 5-dimension Questionnaire.

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Ckd Registry Aids Inquiry

While COPD is associated with higher mortality in the general population, its mortality impact on CKD patients, as well as its prevalence, had not previously been thoroughly investigated.

To gain insight on these issues, Dr. Nally and colleagues including lead investigator Shankar Navaneethan, MD, of Baylor College of Medicine conducted an analysis using Cleveland Clinics electronic medical record -based CKD registry.

The registry was established to develop quality-of-care programs, facilitate disease outcomes research and evaluate CKD intervention efforts. Its large cohort enables researchers to examine CKD comorbidity subsets that may be small, percentagewise, but still represent thousands of patients and generate statistically robust data and observations.

Renal Involvement In Chronic Obstructive Pulmonary Disease

Understanding What Causes COPD

Renal involvement in chronic respiratory diseases is commonly observed in clinical practice. Several studies have reported that prevalence of renal failure is higher in patients with diseases affecting mainly the lungs, especially in chronic obstructive pulmonary disease . This evidence is remarkable having considered that COPD is the seventh most frequent chronic disease in the world and it is expected to reach the fourth place in 2020 . COPD is considered the result of inflammatory processes of the airways and destructive changes of lung parenchyma, which lead to a progressive and irreversible airflow limitation. Inhalation of toxic gases and particles, in first place tobacco smoke, are the main factors capable of triggering these processes, but there is evidence that other elements and the genetic status may also play a role . COPD is a complex and heterogeneous disease, frequently associated with several comorbidities . It is estimated that in patients with COPD, concurrent diseases are often responsible for a higher morbidity and mortality than the respiratory disease itself . The frequent association of a lot of other diseases with COPD has been for a long time considered consequence of their high prevalence in elderly people. However, increasing evidence supports the idea that COPD per se has a role in the development of extrapulmonary problems, to the extent that some authors consider COPD a systemic inflammatory disease .

Fig. 1

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How Can I Minimize The Likelihood Of Developing Kidney Problems With Copd

Improving your oxygen levels can help reduce the likelihood of hypoxia, which will also reduce the likelihood that your organs will be affected by your COPD. You can improve your oxygen levels by participating in pulmonary rehabilitation, practicing breathing and coughing techniques that help you breathe better, taking certain medications that can open your airways and using supplemental oxygen therapy.

As it turns out, some of the treatments that are excellent for COPDlike moderate exercise, oxygen therapy and a healthy dietare also great for the health of your kidneys! In honor of National Kidney Month, commit to treating both your COPD and kidneys by taking steps to keep your body healthy and to improve your oxygen saturation. Ask your doctor to help you decide which treatments are best for your COPD and to assess your risk of kidney problems before you experience symptoms.

How Inogen Can Make Oxygen Therapy Easier

Inogen, an innovator of portable oxygen concentrators, believes that oxygen therapy should help improve your quality of life, not hinder it. As a result, we created portable oxygen concentrators that are small and lightweight, allowing you to get the oxygen you need anytime, anywhere. Inogens compact portable oxygen concentrators can be used at home or on the go, offering endless supplemental oxygen as long as you have a charged battery or an AC or DC power source. Whatever you want to dowhether it is traveling, enjoying time with friends or spending quality time at home with your familyInogens portable concentrators allow you to receive the oxygen treatments you need at the same time. They are not only portable, but also quiet and easy to use, so they will not get in the way of your active life. Inogens products are made to improve your freedom, mobility and independence, so you get the supplemental oxygen you need for your COPD, without being tethered to a tank. Find out more about how Inogen portable oxygen concentrators can benefit your COPD, while you continue doing the things you love. for more information, and talk to your doctor about whether portable oxygen concentrators are right for you.

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Kidney Involvement During Covid

Li et al. analyzed kidney function in 193 COVID-19 patients and found that 31% of patients had an elevated level of blood urea nitrogen and 22% had increased serum creatinine. These authors also found also that in 147 patients, 60% exhibited proteinuria and 48% exhibited hematuria . D-dimer was elevated in 70% of 182 patients and high levels of D-dimer were common in severe and deceased cases . In another retrospective study of 333 patients, about 75% experienced urine dipstick abnormalities or AKI . In the first studies during the pandemic spread, incidence of AKI was reported from 3 to 9% of patients, but more recent studies reported an incidence rate of 15% . In one observational study of 5,449 hospitalized patients, the incidence of AKI was 36.6 with 14.3% of patients requiring dialysis and was even higher in patients admitted to the ICU . Moreover, patients with AKI had higher mortality compared to those without AKI .

AKI is more common among patients with more severe disease, particularly in those recovering in the ICU, and is considered a negative prognostic factor for survival . In a retrospective study of 333 patients with COVID-19 pneumonia, those who presented with kidney dysfunction had higher mortality rates than patients without kidney involvement .

Implications Of Renal Dysfunction In Patients With Chronic Pulmonary Disease

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The kidneys, as well as the lungs, participate to the maintenance of the acid-base balance and therefore blood pH . Particularly, kidneys are the main organs involved when the acidbase balance is chronically impaired due to a respiratory cause .

Fig. 2

In cases of pump failure with hypoventilation, e.g., due to emphysema or neuromuscular diseases, carbon dioxide retention is frequently observed. A sudden worsening of alveolar ventilation can provoke an acute increase in blood CO2 levels, which rapidly reduces pH to values of acidosis .

If respiratory acidosis persists, kidneys respond by retaining bicarbonate ions .

This mostly occurs because the increase in CO2 at the level of renal tubular cells stimulates the secretion of H+ ions and the elimination of more acid urine, while HCO3 ions are reabsorbed.

In the case of renal impairment, acidbase balance is not efficiently restored, resulting in prolonged blood acidosis and suffering for the whole body.

When renal failure occurs in COPD patients, the compensatory role of kidney in respiratory acidosis may be less effective, resulting in a reduced ammoniagenesis and titratable acidity production with consequent limited rise of serum bicarbonate and a more severe acidosis. Clinical reports have demonstrated that bicarbonate levels in these patients are inversely related to survival and that concomitant renal failure is predictive of death and risk of exacerbation .

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Conditions In Which Lungs And Kidneys Are Both Targets Of Disease

Lungs and kidneys are different organs with their own body localization, structure, and function, but it is a shared concept that they are not completely independent from each other and can suffer damages concurrently in the course of systemic diseases . Vasculitides and autoimmune disorders are the best-known examples. Goodpastures syndrome is an autoimmune disease characterized by the production of antibodies which affect both lungs and kidneys. Antineutrophil cytoplasmic antibody -associated vasculitides are a small group of necrotizing vasculitides including Granulomatosis withpolyangiitis , Microscopic polyangiitis , and Eosinophilic granulomatosis with polyangiitis .

Table 1 Diseases that can affect lungs and kidneys, and their possible manifestations

GPA, also known as Wegeners granulomatosis, is a potentially fatal vasculitis affecting small- and medium-size vessels, often causing a granulomatous inflammation of the upper and lower respiratory tracts and a pauci-immune glomerulonephritis.

EGPA is another vasculitis affecting mainly small vessels with almost constant respiratory involvement and possible renal dysfunction. All the aforementioned diseases are acknowledged causes of pulmonary-renal syndrome, involving pulmonary vascular beds with diffuse alveolar hemorrhage and kidney damage, in particular glomerulonephritis.

Kidney Impairment Can Be Costly

Although renal impairment is often reversible if the offending drug is discontinued, the condition can be costly and may require multiple interventions, including hospitalization, Dr. Naughton explained. To help you avoid getting to that point, we learned about medications that commonly cause kidney damage from Rebekah Krupski, PharmD, RPh, pharmacy resident at the Cleveland Clinic and clinical instructor of pharmacy practice at Northeast Ohio Medical University.

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Heart Disease And Chronic Kidney Disease

The heart and the kidneys work closely together. When there is a problem with one, things can go wrong in the other. Heart disease can cause CKD, and CKD can also cause heart disease.

  • When you have heart disease, your heart may not pump blood in the right way. Your heart may become too full of blood. This causes pressure to build in the main vein connected to your kidneys, which may lead to a blockage and a reduced supply of oxygen rich blood to the kidneys. This can lead to kidney disease.
  • When the kidneys are not working well, your hormone system, which regulates blood pressure, has to work harder to increase blood supply to the kidneys. When this happens, your heart has to pump harder, which can lead to heart disease.


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