Prevalence of renal and hepatobiliary disease, laboratory abnormalities, and potentially toxic medication exposures among persons with COPD

Figures & data

Table 1 Prevalence of renal disease in chronic obstructive pulmonary disease cases and controls

Condition (ICD-9 code)	Cases (n = 2284)	Controls (n = 5959)	P value
Total patients with any renal or urinary tract diagnosis (580–599.x; excluding 588)*	714 (31.3)	1260 (21.1)	<0.001
Acute glomerulonephritis (580.x)	1 (0.04)	2 (0.03)	0.828
Nephrotic syndrome (581.x)	6 (0.26)	4 (0.07)	0.022
Chronic glomerulonephritis (582.x)	1 (0.04)	1 (0.02)	0.481
Nephritis and nephropathy (583.x)	26 (1.14)	46 (0.77)	0.110
Acute renal failure (584.x)	32 (1.40)	35 (0.59)	<0.001
Chronic renal failure (585.x)	66 (2.89)	47 (0.79)	<0.001
Renal failure, unspecified (586)	25 (1.09)	26 (0.44)	<0.001
Renal sclerosis, unspecified (587)	0 (0.00)	1 (0.02)	0.530
Disorders secondary to renal disease (588)	17 (0.74)	15 (0.25)	<0.001
Kidney infections (590.x)	7 (0.31)	8 (0.13)	0.101
Hydronephrosis (591)	9 (0.39)	11 (0.18)	0.084
Calculi of kidney and ureter (592.x)	36 (1.58)	98 (1.64)	0.826
Other disorders of ureter (593.x)	180 (7.88)	218 (3.66)	<0.001
Calculus of lower tract (594.x)	5 (0.22)	8 (0.13)	0.386
Cystitis (595.x)	9 (0.39)	15 (0.25)	0.283
Other disorders of bladder (596.x)	28 (1.23)	67 (1.12)	0.699
Urethritis (597.x)	0 (0.00)	5 (0.08)	0.166
Urethral stricture (598.x)	8 (0.35)	15 (0.25)	0.448
Other disorders of the urinary tract (599.x)	371 (16.2)	872 (14.6)	0.068
Subtypes of 599.x
599.0 urinary tract infection	297 (13.0)	702 (11.8)	0.128
599.2 urethral diverticulum	1 (0.04)	1 (0.02)	0.481
599.3 urethral caruncle	0 (0.00)	2 (0.03)	0.381
599.4 urethral false passage	0 (0.00)	3 (0.05)	0.284
599.6 urinary obstruction, NOS	6 (0.26)	3 (0.05)	0.009
599.7 hematuria	105 (4.60)	248 (4.16)	0.382
599.8 other specified disorders	2 (0.09)	6 (0.10)	0.864
599.9 other unspecified	5 (0.22)	8 (0.13)	0.386

Notes:*Patients may have more than one renal or urinary tract diagnosis. Values expressed as the number of patients and percent (cases/100) of the COPD or control cohort. Disease categories without a patient in either cohort were not listed.

Abbreviation: NOS, not otherwise specified.

Table 2 Diagnosed hepatic, gallbladder, and pancreatic diseases among chronic obstructive pulmonary disease cases and controls

	Cases (n = 2284)	Controls (n = 5959)	P value
Total patients with any hepatic diagnosis* (070.x, 570−573.x)	25 (1.09)	66 (1.11)	0.96
Viral hepatitis including hepatitis A, B, or C (070.x)	10 (0.44)	30 (0.50)	0.67
Acute and subacute hepatic necrosis (570.x)	0 (0.00)	2 (0.03)	0.38
Alcohol-related liver diseases (571.1−0.3)	4 (0.18)	11 (0.18)	0.93
Non-alcohol related liver diseases (571.4−0.9)	10 (0.44)	32 (0.54)	0.57
Abscess and other liver infections (572.0, 572.1, 573.1−573.3)	4 (0.18)	8 (0.13)	0.75
All gallbladder disease including cholelithiasis (574.x−576.x)	63 (2.76)	97 (1.63)	<0.001
All pancreatic disease (577.x)	32 (1.40)	36 (0.60)	<0.001

Notes: Values expressed as the number of patients and percent (cases/100) of the chronic obstructive pulmonary disease cases or controls.

* Patients may have more than one specific hepatic diagnosis.

Table 3 Prevalence of laboratory abnormalities among COPD cases and controls

Test		No tests obtained	One or more tests-all normal	One or more tests-at least one elevated
Liver function tests
Alkaline phosphatase	COPD	*311 (13.6)	*1659 (72.6)	*314 (13.7)
(>Upper limit nl)	Control	1292 (21.7)	4104 (68.9)	563 (9.45)
Alkaline phosphatase	COPD	*311 (13.6)	*1929 (84.5)	44 (1.9)
(>2 × Upper limit nl)	Control	1292 (21.7)	4572 (76.7)	95 (1.6)
ALT (SGPT)	COPD	*326 (14.3)	*1757 (76.9)	*201 (8.8)
(>Upper limit nl)	Control	1227 (20.6)	4392 (73.7)	340 (5.7)
ALT (SGPT)	COPD	*326 (14.3)	*1886 (82.6)	*72 (3.2)
(>2 × Upper limit nl)	Control	1227 (20.6)	4622 (77.6)	110 (1.8)
AST (SGOT)	COPD	*300 (13.1)	*1707 (74.7)	*277 (12.1)
(>Upper limit nl)	Control	1235 (20.7)	4313 (72.4)	411 (6.90)
AST (SGOT)	COPD	*300 (13.1)	*1880 (82.3)	*104 (4.5)
(>2 × Upper limit nl)	Control	1235 (20.7)	4563 (76.6)	161 (2.7)
Total bilirubin	COPD	*308 (13.2)	*1725 (75.5)	*251 (11.0)
(>Upper limit nl)	Control	1294 (21.7)	4165 (69.9)	500 (8.39)
Total bilirubin	COPD	*308 (13.2)	*1924 (84.2)	^†52 (2.3)
(>2 × Upper limit nl)	Control	1294 (21.7)	4575 (76.8)	90 (1.5)
LDH	COPD	*2132 (93.9)	*97 (4.2)	*55 (2.4)
(>Upper limit nl)	Control	5779 (97.0)	124 (2.0)	56 (0.9)
LDH	COPD	*2132 (93.9)	*146 (6.4)	6 (0.2)
(>2 × Upper limit nl)	Control	5779 (97.0)	161 (2.7)	19 (0.3)
Amylase	COPD	*1410 (61.7)	*799 (35.0)	*75 (3.3)
(>Upper limit nl)	Control	4678 (78.5)	1187 (19.9)	94 (1.6)
Amylase	COPD	*1410 (61.7)	*848 (37.1)	26 (1.1)
(>2 × Upper limit nl)	Control	4678 (78.5)	1249 (20.9)	32 (0.5)
Renal function tests
Blood urea nitrogen	COPD	*237 (10.4)	*1395 (61.1)	*652 (28.5)
(>Upper limit nl)	Control	1044 (17.5)	3970 (66.2)	945 (15.8)
Blood urea nitrogen	COPD	*237 (10.4)	*1895 (83.0)	*152 (6.7)
(>2 × Upper limit nl)	Control	1044 (17.5)	4762 (79.9)	153 (2.6)
Creatinine	COPD	*221 (9.68)	*1445 (63.3)	*618 (27.1)
(>Upper limit nl)	Control	954 (16.0)	4008 (67.3)	997 (16.7)
Creatinine	COPD	*221 (9.68)	*1946 (85.2)	*117 (5.1)
(>2 × Upper limit nl)	Control	954 (16.0)	4878 (81.9)	127 (2.1)

Notes: Values expressed as the number of patients and row percent of the COPD or control group.

* Difference between COPD and control significant (P < 0.01).

Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; COPD, chronic obstructive pulmonary disease; ULN, upper limit of normal; LDH, lactate dehydrogenase; SGOT, serum glutamic oxaloacetic transaminase; SPGT, serum glutamic pyruvate transaminase.

Table 4 Mean prescription fills during the three-year study period among chronic obstructive pulmonary disease cases and matched controls

	All drugs	Potentially nephrotoxic	Potentially hepatotoxic
Anti-infectives and antibiotics
COPD	*8.7 (11.8)	*2.4 (4.5)	*6.3 (8.7)
Control	5.1 (9.0)	1.6 (3.3)	3.3 (6.0)
Antineoplastics
COPD	0.9 (5.3)	0.3 (4.5)	0.6 (4.4)
Control	0.8 (5.2)	0.3 (3.3)	0.5 (4.3)
Autonomic agents
COPD	*20.4 (31.6)	0	^†0.5 (3.1)
Control	2.6 (8.4)	0	0.4 (2.6)
Blood formation and anticoagulation
COPD	*2.9 (11.0)	0	*1.2 (4.5)
Control	1.5 (7.0)	0	0.7 (3.4)
Cardiovascular
COPD	*35.6 (49.4)	*9.6 (17.4)	*12.4 (23.9)
Control	30.3 (45.9)	8.7 (17.3)	11.3 (22.6)
Central nervous system agents
COPD	*32.7 (50.6)	*11.3 (11.3)	*12.4 (22.0)
Control	18.8 (34.4)	8.2 (16.2)	7.6 (15.8)
Electrolytic, caloric, and water balance
COPD	*13.9 (25.9)	*4.7 (8.6)	*5.7 (14.0)
Control	7.3 (18.3)	2.6 (6.4)	2.1 (8.8)
Gastrointestinal drugs
COPD	*8.1 (15.6)	^†0.14 (1.9)	*4.1 (10.5)
Control	5.4 (13.4)	0.07 (1.7)	2.8 (9.2)
Hormones (natural and synthetic)
COPD	*23.1 (33.5)	0.03 (0.6)	*4.5 (13.4)
Control	17.6 (30.5)	0.01 (0.8)	4.9 (13.6)
Unclassified therapeutics
COPD	6.5 (15.8)	0.1 (2.2)	0
Control	4.6 (13.0)	0.1 (2.7)	0
Eye, ear, nose, and throat preparations
COPD	3.9 (10.1)	0	0.10 (1.2)
Control	3.7 (10.3)	0	0.09 (0.9)
Total
COPD	*169.6 (154)	*17.6 (18.5)	*27.4 (28.2)
Control	106.7 (116)	13.6 (15.5)	19.9 (22.9)

Notes: Values expressed as the mean (standard deviation).

* P < 0.01;

† P < 0.05.

Abbreviation: COPD, chronic obstructive pulmonary disease.