Lower incidence of death from chronic renal disease in patients with nonlethal emphysema: a statistical study

Pulmonary emphysema is an extraordinarily prevalent disease, especially among men, and is found in about 40% of all autopsies at this Veterans Medical Center. However, in the great majority of cases, it is an incidental finding, and the individual has died of another lesion, either pulmonary or in another organ system. These facts have permitted the authors to examine the interrelationships between presence or absence of emphysema and the cause of death in a consecutive series of 1033 autopsies. Results show that chronic renal disease is much less common as a cause of death in persons with, than in those without, emphysema. Since emphysema is closely associated with smoking, the data also show a reduction in risk of death from renal disease in smokers. These trends persist, even when individuals who have died from smoking-related diseases are eliminated from the population. Further analyses suggest that it is the presence of emphysema which is mainly responsible for this effect. A likely mechanism for it is proposed.