Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort Study
ABSTRACT Introduction Bronchiectasis exacerbation (BE) is associated with unfavorable sequelae in other organs such as the cardiovascular system; data regarding its impact on adverse term renal outcomes, however, is lacking. Methods A territory‐wide retrospective cohort study was conducted in Hong K...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-01-01
|
| Series: | The Clinical Respiratory Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/crj.70029 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832584917031059456 |
|---|---|
| author | Wang Chun Kwok Chung Ki Tsui Leung Sze Him Isaac Chun Ka Emmanuel Wong Terence Chi Chun Tam James Chung Man Ho Desmond Yat Hin Yap |
| author_facet | Wang Chun Kwok Chung Ki Tsui Leung Sze Him Isaac Chun Ka Emmanuel Wong Terence Chi Chun Tam James Chung Man Ho Desmond Yat Hin Yap |
| author_sort | Wang Chun Kwok |
| collection | DOAJ |
| description | ABSTRACT Introduction Bronchiectasis exacerbation (BE) is associated with unfavorable sequelae in other organs such as the cardiovascular system; data regarding its impact on adverse term renal outcomes, however, is lacking. Methods A territory‐wide retrospective cohort study was conducted in Hong Kong between 1/1/1993 and 31/12/2017. All patients with bronchiectasis followed in the public healthcare system in 2017 were classified as “Exacerbators” or “Non‐Exacerbators,” and their adverse renal outcomes (renal progression [decrease in eGFR by 30 mL/min lasted for more than 12 months during follow up], acute kidney injury [AKI], and annual rate of eGFR decline) in the ensuing 7 years were compared. Results were also analyzed in the 1:1 propensity score matched (PSM) cohort. Results A total of 7929 patients (1074 “Exacerbators” group and 6855 “Non‐exacerbators”) were followed for 6.2 ± 1.6 years. A total of 1570 patients (19.8%) had renal progression, and 935 (11.8%) patients developed AKI. “Exacerbators” showed significantly increased risk of renal progression (adjusted odds ratio [aOR] 1. 27 [95% CI 1.08–1.50, p = 0.003]), more rapid eGFR decline (−3.67 [−1.74 to −6.54] vs. −3.03 [−1.56 to −5.12] mL/min/1.73 m2/year, p = 0.004) and AKI (aOR 1.99; 95% CI 1.44–2.73, p < 0.001) than the “Non‐exacerbators.” Annual number of BE was associated with renal progression (aOR 1.45; 95% CI 1.22–1.72, p < 0.001) and AKI (aOR 2.00; 95% CI 1.38–2.91, p < 0.001). Results were consistent in the analysis with the PSM cohort. Conclusions Renal progression and AKI are common among patients with bronchiectasis, and BE is an independent risk factor for adverse renal outcomes. |
| format | Article |
| id | doaj-art-29432f6a3b404a7c95e96a56c0c0cfdf |
| institution | Kabale University |
| issn | 1752-6981 1752-699X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Clinical Respiratory Journal |
| spelling | doaj-art-29432f6a3b404a7c95e96a56c0c0cfdf2025-01-27T08:28:30ZengWileyThe Clinical Respiratory Journal1752-69811752-699X2025-01-01191n/an/a10.1111/crj.70029Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort StudyWang Chun Kwok0Chung Ki Tsui1Leung Sze Him Isaac2Chun Ka Emmanuel Wong3Terence Chi Chun Tam4James Chung Man Ho5Desmond Yat Hin Yap6Division of Respiratory Medicine and Critical Care Medicine, Department of Medicine, Queen Mary Hospital The University of Hong Kong Pok Fu Lam Hong Kong SAR ChinaDivision of Respiratory Medicine and Critical Care Medicine, Department of Medicine, Queen Mary Hospital The University of Hong Kong Pok Fu Lam Hong Kong SAR ChinaDepartment of Statistics The Chinese University of Hong Kong Sha Tin Hong Kong SAR ChinaDivision of Respiratory Medicine and Critical Care Medicine, Department of Medicine, Queen Mary Hospital The University of Hong Kong Pok Fu Lam Hong Kong SAR ChinaDivision of Respiratory Medicine and Critical Care Medicine, Department of Medicine, Queen Mary Hospital The University of Hong Kong Pok Fu Lam Hong Kong SAR ChinaDivision of Respiratory Medicine and Critical Care Medicine, Department of Medicine, Queen Mary Hospital The University of Hong Kong Pok Fu Lam Hong Kong SAR ChinaDivision of Nephrology, Department of Medicine, Queen Mary Hospital The University of Hong Kong Pok Fu Lam Hong Kong SAR ChinaABSTRACT Introduction Bronchiectasis exacerbation (BE) is associated with unfavorable sequelae in other organs such as the cardiovascular system; data regarding its impact on adverse term renal outcomes, however, is lacking. Methods A territory‐wide retrospective cohort study was conducted in Hong Kong between 1/1/1993 and 31/12/2017. All patients with bronchiectasis followed in the public healthcare system in 2017 were classified as “Exacerbators” or “Non‐Exacerbators,” and their adverse renal outcomes (renal progression [decrease in eGFR by 30 mL/min lasted for more than 12 months during follow up], acute kidney injury [AKI], and annual rate of eGFR decline) in the ensuing 7 years were compared. Results were also analyzed in the 1:1 propensity score matched (PSM) cohort. Results A total of 7929 patients (1074 “Exacerbators” group and 6855 “Non‐exacerbators”) were followed for 6.2 ± 1.6 years. A total of 1570 patients (19.8%) had renal progression, and 935 (11.8%) patients developed AKI. “Exacerbators” showed significantly increased risk of renal progression (adjusted odds ratio [aOR] 1. 27 [95% CI 1.08–1.50, p = 0.003]), more rapid eGFR decline (−3.67 [−1.74 to −6.54] vs. −3.03 [−1.56 to −5.12] mL/min/1.73 m2/year, p = 0.004) and AKI (aOR 1.99; 95% CI 1.44–2.73, p < 0.001) than the “Non‐exacerbators.” Annual number of BE was associated with renal progression (aOR 1.45; 95% CI 1.22–1.72, p < 0.001) and AKI (aOR 2.00; 95% CI 1.38–2.91, p < 0.001). Results were consistent in the analysis with the PSM cohort. Conclusions Renal progression and AKI are common among patients with bronchiectasis, and BE is an independent risk factor for adverse renal outcomes.https://doi.org/10.1111/crj.70029acute kidney injurybronchiectasischronic kidney diseaseexacerbationrenal progression |
| spellingShingle | Wang Chun Kwok Chung Ki Tsui Leung Sze Him Isaac Chun Ka Emmanuel Wong Terence Chi Chun Tam James Chung Man Ho Desmond Yat Hin Yap Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort Study The Clinical Respiratory Journal acute kidney injury bronchiectasis chronic kidney disease exacerbation renal progression |
| title | Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort Study |
| title_full | Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort Study |
| title_fullStr | Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort Study |
| title_full_unstemmed | Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort Study |
| title_short | Bronchiectasis Exacerbation Increases the Risk of Adverse Renal Outcomes—Results From a Large Territory‐Wide Cohort Study |
| title_sort | bronchiectasis exacerbation increases the risk of adverse renal outcomes results from a large territory wide cohort study |
| topic | acute kidney injury bronchiectasis chronic kidney disease exacerbation renal progression |
| url | https://doi.org/10.1111/crj.70029 |
| work_keys_str_mv | AT wangchunkwok bronchiectasisexacerbationincreasestheriskofadverserenaloutcomesresultsfromalargeterritorywidecohortstudy AT chungkitsui bronchiectasisexacerbationincreasestheriskofadverserenaloutcomesresultsfromalargeterritorywidecohortstudy AT leungszehimisaac bronchiectasisexacerbationincreasestheriskofadverserenaloutcomesresultsfromalargeterritorywidecohortstudy AT chunkaemmanuelwong bronchiectasisexacerbationincreasestheriskofadverserenaloutcomesresultsfromalargeterritorywidecohortstudy AT terencechichuntam bronchiectasisexacerbationincreasestheriskofadverserenaloutcomesresultsfromalargeterritorywidecohortstudy AT jameschungmanho bronchiectasisexacerbationincreasestheriskofadverserenaloutcomesresultsfromalargeterritorywidecohortstudy AT desmondyathinyap bronchiectasisexacerbationincreasestheriskofadverserenaloutcomesresultsfromalargeterritorywidecohortstudy |