A new study led by Professor of Medicine, Austin G. Stack, Graduate Entry Medical School has established a strong link between chronic obstructive pulmonary disease (COPD) and adverse outcomes in end stage kidney disease. The study found increased mortality risk among dialysis patients presenting with COPD - chronic obstructive pulmonary disease.

Consultant Nephrologist, Professor Stack and his team analysed data on almost 800,000 U.S. dialysis patients who commenced dialysis between 1995 and 2004.
The researchers found that COPD is a common diagnosis among patients who begin dialysis; has increased in prevalence over time and is strongly associated with cardiovascular disease, poor functional status, advancing age and tobacco use.

Professor Stack explains; “Our study found that patients starting dialysis and who have COPD have a 20% higher risk of death. The risks were much greater for smokers; 28% higher risk, than non-smokers, 21 % higher risk. Equally importantly, their chances of receiving a successful kidney transplant were reduced by a substantial 44 %. Dialysis patients who continued to smoke fared even worse with an overall 53% reduction in likelihood of transplantation”

Emerging evidence suggests that chronic kidney disease is an important co-morbidity in patients with COPD, Dr. Stack added; “Few studies have addressed the impact of COPD on clinical outcomes among patients with advanced kidney failure. To our knowledge this is the first large-scale study to examine specifically the conjoint impact of COPD and smoking in a cohort with end-stage kidney disease.” Our study suggests the need for greater recognition of COPD in patients commencing dialysis, better treatment strategies and the need for co-operation between general practitioners, respiratory specialists and nephrologists in the care of these high-risk patients.”

The study is entitled ‘The Impact of Chronic Obstructive Pulmonary Disease and Smoking on Mortality and Kidney Transplantation in End-Stage Kidney Disease’ authored by Kent BD, Eltayeb EE, Woodman A, Mutwali A, Nguyen HT, Stack AG. Sep; 2012;36:287–295. The research was published in the American journal of Nephrology, September 2012.

The Graduate Entry Medical School is leading a number of projects to evaluate the health status and clinical outcomes for patients with kidney disease. The study was performed at the Regional Kidney Centre, Department of Medicine, Letterkenny General Hospital, Donegal, and Graduate Entry Medical School, Faculty of Education and Health Sciences, University of Limerick.