Clinical study of early renal injury in elderly patients with overlap syndrome
Received:August 30, 2018  
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DOI:10.11915/j.issn.1671-5403.2019.02.021
Key words:pulmonary disease, chronic obstructive; overlap syndrome; cystatin C; β2-microglobulin; early renal injury
Author NameAffiliationE-mail
ZOU Chun-Fang Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China  
GU Wei Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China guw2001@126.com 
WANG Li Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China  
CHEN Yu-Bao Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China  
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Abstract:
      Objective To investigate early renal injury in overlap syndrome (OS) and related indicators. Methods Enrolled in the study were 16 patients with OS (OS group) and 42 with chronic obstructive pulmonary disease (COPD; COPD group) treated in the Department of Respiratory and Critical Care Medicine of Nanjing First Hospital from January 2014 to August 2018. During the same period, 30 healthy people without hypoxic diseases were enrolled as control group. Measurement was made of the pulmonary indicators [percentage of predicted forced expiratory volume in 1 second (FEV1%), percentage of predicted forced vital capacity (FVC%), forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC)], blood gas analysis [partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2)], indicators of renal function [blood urea nitrogen (BUN), serum creatinine(SCr), endogenous creatinine clearance rate (Ccr), cystatin C(Cys-C) and β2-microglobulin (β2-MG)]. The difference of the parameters among groups was observed. SPSS statistics 22.0 was used for statistical analysis. According to the data type, analysis of variance (ANOVA), LSD pairwise comparison or χ2 test was used for comparison among groups, and Spearman rank correlation for the correlation between Cys-C or β2-MG and other indicators. Results The OS and COPD groups scored significantly higher than the control group in COPD assessment test (CAT), PaCO2, Cys-C and β2-MG but significantly lower in PaO2, FEV1%, FVC% and FEV1/FVC (P<0.05), but there were no significant differences in BUN, SCr and Ccr among the three groups (P>0.05). Compared with the COPD group, CAT, Cys-C and β2-MG in the OS group were significantly higher(P<0.05). The correlation analysis showed that Cys-C and β2-MG were positively correlated with CAT score(Cys-C:r=0.722,P=0.000;β2-MG:r=0.287, P=0.029)and negatively correlated with PaO2(Cys-C:r=-0.355, P=0.006;β2-MG:r=-0.471, P=0.000), all with statistical significance(P<0.05).Conclusion Measurement of serum Cys-C and β2-MG in OS patients can help monitor the degree of early renal injury, and Cys-C and β2-MG are closely associated with hypoxia.
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