Lung Dysfunction and Chronic Kidney Disease: A Complex Network of Multiple Interactions.

Area of Science:

• Nephrology
• Pulmonology
• Internal Medicine

Background:

• Chronic kidney disease (CKD) is a global health crisis affecting over 10% of the population, with increasing mortality.
• CKD disproportionately impacts low- and middle-income countries, exacerbating health inequities.
• The interplay between lung and kidney physiology presents complex clinical challenges.

Purpose of the Study:

• To underscore the critical need for harmonized clinical event definitions in pneumology and renal medicine.
• To advocate for the routine integration of pulmonary function tests (PFTs) in CKD patient management.
• To explore novel, pathophysiology-based strategies for disease-specific management.

Main Methods:

• This article is a review and conceptual discussion.
• It synthesizes current understanding of cardiorenal-pulmonary interactions.
• It proposes a framework for enhanced clinical practice and research.

Main Results:

• CKD significantly disrupts lung physiology, leading to ventilatory control alterations, pulmonary congestion, and vascular disease.
• Renal dysfunction in CKD results in fluid and electrolyte imbalances and further functional decline.
• Harmonizing definitions and incorporating PFTs can lead to improved diagnostic and therapeutic approaches.

Conclusions:

• Integrating PFTs into routine CKD care is essential for a comprehensive understanding of patient status.
• Standardizing clinical event definitions across specialties will facilitate collaborative research and care.
• Developing pathophysiology-based management strategies holds promise for improving outcomes in patients with co-existing lung and kidney disease.