Chronic lung diseases and kidney disease: pathophysiology and management

Abstract

Acute kidney injury (AKI) is a critical complication in patients with chronic lung diseases (CLD), particularly during acute exacerbations. This review focuses on the pathophysiological mechanisms linking CLD to AKI and highlights key clinical strategies to mitigate its impact. CLD patients with pre-existing kidney dysfunction face an increased risk of AKI due to impaired gas exchange, systemic inflammation, and neurohormonal activation. Hypoxemia and hypercapnia contribute to kidney hypoperfusion, endothelial dysfunction, and sodium–water imbalances, exacerbating renal injury. Current management strategies prioritize minimizing mechanical ventilation-related damage, optimizing hemodynamics, and preventing AKI progression. A multidisciplinary approach is essential to improving outcomes, emphasizing early identification and targeted interventions for CLD-associated AKI.