COPD and kidney disease: not so far apart?

This review synthesizes current literature on the epidemiology, mechanistic links, and clinical consequences of the COPD-CKD association. In addition to evaluating established risk factors such as age and tobacco smoking, we discuss emerging insights into the roles of novel biomarkers and epigenetic modifications in bridging the lung-kidney axis. The review further examines how the presence of CKD influences clinical management in COPD patients, including impacts on drug dosing, electrolyte balance, acid-base homeostasis, and outcomes during acute exacerbations, and conversely, how COPD can adversely affect renal function. Recognizing that the dual burden of COPD and CKD may worsen patient prognosis by increasing the risk for cardiovascular events, hospitalizations, and mortality, we advocate for early detection, routine screening using both creatinine and cystatin C measurements, and a multidisciplinary approach to care. Finally, we outline future research directions aimed at standardizing screening protocols, refining risk stratification, and developing targeted therapies that address shared pathogenic pathways.