Lung-kidney interactions and their role in chronic kidney disease-associated pulmonary diseases

Am J Physiol Lung Cell Mol Physiol. 2022 May 1;322(5):L625-L640. doi: 10.1152/ajplung.00152.2021. Epub 2022 Mar 10.

Abstract

Chronic illnesses rarely present in a vacuum, devoid of other complications, and chronic kidney disease is hardly an exception. Comorbidities associated with chronic kidney disease lead to faster disease progression, expedited dialysis dependency, and a higher mortality rate. Although chronic kidney disease is most commonly accompanied by cardiovascular diseases and diabetes, there is clear cross talk between the lungs and kidneys pH balance, phosphate metabolism, and immune system regulation. Our present understanding of the exact underlying mechanisms that contribute to chronic kidney disease-related pulmonary disease is poor. This review summarizes the current research on kidney-pulmonary interorgan cross talk in the context of chronic kidney disease, highlighting various acute and chronic pulmonary diseases that lead to further complications in patient care. Treatment options for patients presenting with chronic kidney disease and lung disease are explored by assessing activated molecular pathways and the body's compensatory response mechanisms following homeostatic imbalance. Understanding the link between the lungs and kidneys will potentially improve health outcomes for patients and guide healthcare professionals to better understand how and when to treat each of the pulmonary comorbidities that can present with chronic kidney disease.

Keywords: FGF23; chronic kidney disease; inflammation; interorgan cross talk; phosphate.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Female
  • Humans
  • Kidney / metabolism
  • Lung
  • Lung Diseases* / metabolism
  • Male
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / metabolism