Lung function and measured glomerular filtration rate decline in the general population

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ID: 337347
2026
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Abstract
Abstract Background The prevalence of chronic kidney disease (CKD) and respiratory diseases is rising. Reduced lung function contributes to hypoxia and low-grade inflammation, but its relationship to age-related decline in glomerular filtration rate (GFR) remains unknown. Methods In the Renal Iohexol Clearance Survey (RENIS), we repeatedly measured GFR (mGFR) using iohexol clearance over a median of 11 years in 1 837 individuals from the general population without self-reported diabetes, kidney disease, or cardiovascular disease. A linear mixed model examined the relationship between baseline lung function, measured by spirometry, and changes in mGFR. Logistic regression estimated the odds ratio (OR) for accelerated mGFR decline. Interval-censored Cox regression was used to estimate the hazard ratio (HR) for incident CKD. Results Lower %-predicted forced expiratory volume in 1 second (FEV1%) and %-predicted forced vital capacity (FVC%) were each associated with steeper mean mGFR decline. Per 10% decrease, the estimated difference in annual mGFR decline was − 0.05 mL/min/1.73 m²/year for FEV1% (95% confidence interval [CI] −0.09 to − 0.02) and − 0.05 mL/min/1.73 m²/year for FVC% (95% CI − 0.09 to 0.00). These associations were no longer significant after adjustment for smoking. In fully adjusted models, lower FVC% was associated with accelerated mGFR decline in men only (OR 1.32; 95% CI 1.11–1.57 per 10% decrease), and lower FEV1% was associated with incident CKD in men and women (HR 1.15; 95% CI 1.03–1.29). Conclusion Lower lung function was associated with steeper mGFR decline, largely attenuated after adjustment for smoking. Lower FEV1% remained associated with incident CKD.
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Authors Embla P Fuhr, Ludvig Balteskard Rinde, Hasse Melbye, Inger Therese Enoksen, Björn O. Eriksen, Toralf Melsom
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Journal clinical kidney journal
Year 2026
DOI
10.1093/ckj/sfag378
URL
https://doi.org/10.1093/ckj/sfag378
Keywords Keywords not found

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