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Open Access Research article

Bronchial asthma is associated with increased risk of chronic kidney disease

Hui-Ling Huang12, Shinn-Ying Ho12, Chien-Hsun Li13, Fang-Ying Chu1, Li-Ping Ciou1, Hua-Chin Lee1, Wen-Liang Chen12 and Nian-Sheng Tzeng4*

Author Affiliations

1 Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan

2 Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan

3 Department of Surgery, Division of Neurosurgery, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan

4 Department of Psychiatry, Tri-Service General Hospital, School of Medicine and Student Counseling Center, National Defense Medical Center, #325, Sec 2, Cheng-Gong RdNei- Hu District, Taipei City, Taiwan

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BMC Pulmonary Medicine 2014, 14:80  doi:10.1186/1471-2466-14-80

Published: 8 May 2014

Abstract

Background

Bronchial asthma influences some chronic diseases such as coronary heart disease, diabetes mellitus, and hypertension, but the impact of asthma on vital diseases such as chronic kidney disease is not yet verified. This study aims to clarify the association between bronchial asthma and the risk of developing chronic kidney disease.

Methods

The National Health Research Institute provided a database of one million random subjects for the study. A random sample of 141 064 patients aged ≥18 years without a history of kidney disease was obtained from the database. Among them, there were 35 086 with bronchial asthma and 105 258 without asthma matched for sex and age for a ration of 1:3. After adjusting for confounding risk factors, a Cox proportional hazards model was used to compare the risk of developing chronic kidney disease during a three-year follow-up period.

Results

Of the subjects with asthma, 2 196 (6.26%) developed chronic kidney disease compared to 4 120 (3.91%) of the control subjects. Cox proportional hazards regression analysis revealed that subjects with asthma were more likely to develop chronic kidney disease (hazard ratio [HR]: 1.56; 95% CI: 1.48-1.64; p < 0.001). After adjusting for sex, age, monthly income, urbanization level, geographic region, diabetes mellitus, hypertension, hyperlipidemia, and steroid use, the HR for asthma patients was 1.40 (95% CI: 1.33-1.48; p = 0.040). There was decreased HRs in steroid use (HR: 0.56; 95% CI: 0.62-0.61; p < 0.001) in the development of chronic kidney disease. Expectorants, bronchodilators, anti-muscarinic agents, airway smooth muscle relaxants, and leukotriene receptor antagonists may also be beneficial in attenuating the risk of chronic kidney disease.

Conclusions

Patients with bronchial asthma may have increased risk of developing chronic kidney disease. The use of steroids or non-steroidal drugs in the treatment of asthma may attenuate this risk.

Keywords:
Bronchial asthma; Chronic kidney diseases; National Health Insurance Research Dataset