Table 1. Clinical and biochemical characteristics of 404 individuals with various degrees of impairment of renal function divided according to spirometry results indicating normal lung function, obstructive lung disorder (OLD) or restrictive lung disorder (RLD).
|
Normal (n = 252) |
OLD (n = 42) |
RLD (n = 110) |
P value | |
| Demography and clinical characteristics | ||||
| Age (years) | 57 (36–71) | 63 (32–72) | 59 (37–71) | 0.14 |
| Males, (%) | (63) | (67) | (68) | 0.62 |
| Diabetes mellitus, (%) | (21) | (26) | (46) | <0.001 |
| Cardiovascular disease, (%) | (18) | (31) | (48) | <0.001 |
| Framingham CVD risk score (%) | 17.8 (3.8–56.3) | 31.3 (4.5–58.3) | 24.9 (5.3–61.0) | 0.01 |
| Smoker, (%) | (39) | (30) | (37) | 0.56 |
| Mean BP (mmHg) | 109 (91–125) | 106 (90–137) | 107 (90–130) | 0.99 |
| Low physical activity a, n (%) (n = 234/36/105) | 14 (6) | 6 (17) | 24 (23) | <0.001 |
| Urine albumin ≥ 30mg/day, n (%) (n = 190/26/65) | 121 (64) | 19 (73) | 54 (83) | 0.009 |
| eGFR (ml/min/1.73m2) | 13.5(4.6–88.9) | 9.8(4.4–76.4) | 6.9(3.8–68.1) | <0.001 |
| Nutritional status | ||||
| PEW (SGA>1), n (%) (n = 250/40/109) | 17 (7%) | 12 (30%) | 34 (31%) | <0.001 |
| Body mass index, (kg/m2) | 25.2 (20.2–30.8) | 22.9 (18–28.6) | 24.7 (20.3–32.4) | 0.004 |
| Lean body mass index, (kg/m2, n = 249/40/101) | 17.4 (14.6–20.5) | 16.3 (13.2–19.7) | 17.3 (13.6–20.6) | 0.03 |
| Fat body mass index, (kg/m2, n = 249/40/101) | 7.9 (4.6–11.7) | 6.8 (3.9–10.8) | 7.5 (4.1–12.6) | 0.06 |
| % HGSb (%, n = 251/41/107) | 100 (70–122) | 80 (50–106) | 85 (55–122) | <0.001 |
| Total BMD (g/cm2, n = 238/37/93) | 1.17 (1.02–1.31) | 1.14 (0.98–1.29) | 1.15 (1.03–1.33) | 0.30 |
| Markers of metabolism and nutrition | ||||
| Hemoglobin (g/L) | 123 (94–148) | 116 (86–146) | 109 (93–138) | <0.001 |
| Albumin (g/L) | 37 (30–42) | 35 (27–41) | 34 (24–40) | <0.001 |
| IGF-1 (μg /mL, n = 204/29/86) | 155 (81–307) | 170 (53–234) | 158 (65–289) | 0.62 |
| Triglyceride (mmol/L, n = 249/42/109) | 1.6 (0.7–3.3) | 1.7 (0.9–3.3) | 1.7 (0.9–3.3) | 0.57 |
| Total cholesterol (mmol/L, n = 251/42/109) | 5.0 (3.6–6.6) | 5.1 (3.7–7.0) | 4.4 (3.1–6.6) | <0.001 |
| HDL cholesterol (mmol/L, n = 216/39/107) | 1.3 (0.9–2.1) | 1.2 (0.7–2.1) | 1.2 (0.8–2.0) | 0.22 |
| Calcium (mmol/L, = 251/40/108) | 2.4 (2.2–2.8) | 2.5 (2.1–2.7) | 2.4 (2.1–2.7) | 0.22 |
| Phosphate (mmol/L, n = 250/40/108) | 1.4 (0.9–2.5) | 1.5 (0.9–2.6) | 1.8 (0.9–2.7) | <0.001 |
| Intact-PTH (ng/L, n = 248/42/110) | 103 (30–398) | 93 (30–482) | 197 (33–469) | <0.001 |
| Biomarkers of inflammation | ||||
| hsCRP (mg/L) | 2.5 (0.5–14.0) | 4.3 (0.8–52.3) | 7.7 (1.1–30.8) | <0.001 |
| IL-6 (pg/mL, n = 214/37/105) | 3.3 (1.2–10.1) | 8.1 (2.2–18.7) | 6.3 (2.3–21.7) | <0.001 |
| Fibrinogen (g/L, n = 247/41/108) | 3.7 (2.6–5.9) | 4.1 (2.8–6.4) | 5.0 (3.1–6.9) | <0.001 |
| TNF (pg/mL, n = 194/35/96) | 8.9 (4.1–16.7) | 10.3 (3.9–27.4) | 12.8 (6.5–21.4) | <0.001 |
| Leucocytes count (109/L) | 6.8 (4.7–9.6) | 7.4 (5.4–11.3) | 8.3 (5.1–12.4) | <0.001 |
| Medications | ||||
| β-blockers, n (%) (n = 244/40/107) | 122 (50) | 22 (55) | 69 (64) | 0.04 |
| Ca-blocker, n (%) (n = 244/40/107) | 80 (33) | 11 (28) | 43 (40) | 0.26 |
| ACEi/ARB, n (%) (n = 251/41/110) | 149 (59) | 18 (44) | 58 (53) | 0.13 |
| Statins, n (%) (n = 251/41/110) | 56 (22) | 5 (12) | 42 (38) | <0.001 |
| Diuretics, n (%) (n = 249/41/109) | 148 (59) | 29 (71) | 88 (81) | <0.001 |
| Pulmonary function | ||||
| FVC (% predicted) | 94 (83–112) | 82 (59–118) | 69 (51–78) | <0.001 |
| FEV1 (% predicted) | 98 (83–118) | 63 (46–96) | 73 (54–86) | <0.001 |
| PEF (% predicted) | 81 (49–118) | 39 (23–85) | 68 (40–97) | <0.001 |
| FEV1/FVC (%) | 85 (75–95) | 65 (52–69) | 88 (76–96) | <0.001 |
| Pulse oxymetry (% saturation, n = 239/35/102) | 98 (95–99) | 98 (95–99) | 98 (94–99) | 0.45 |
Continuous variables are presented as median (10–90 percentile). Categorical variables are presented as number (n)/percentage (%). Abbreviations: Mean BP, mean blood pressure; GFR, glomerular filtration rate; Total BMD, Total bone mineral density; PEW, protein-energy wasting; SGA, Subjective global nutritional assessment; HDL, high-density lipoprotein; intact-PTH, intact parathyroid hormone; hsCRP, high-sensitivity C-reactive protein; IGF-1, insulin-like growth factor-1; IL-6, interleukin-6; TNF, tumor necrosis factor; ACEi, angiotensin-converting enzyme; ARB, angiotensin 2 receptor blocker; FVC, forced vital capacity; FEV1, forced expiratory volume in the first second; PEF, peak expiratory flow.
aLow physical activity or bed or wheelchair bound (according to questionnaire where patient reported one of four domains: 1) exercise frequently, 2) normal activity, 3) low activity, or 4) bedridden or wheelchair bound)
b % HGS, Handgrip strength as percentage of values for health individuals. OLD; obstructive lung disorder FEV1/FVC <0.70, RLD; restrictive lung disorder, FEV1/FVC ≥0.70 and %FVC <80.