{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T13:06:35Z","timestamp":1791551195172,"version":"4.3.4"},"reference-count":55,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a systemic disorder with clinically significant extrapulmonary manifestations. Among these, renal dysfunction\u2014manifesting as chronic kidney disease (CKD) and acute kidney injury (AKI)\u2014is highly prevalent, frequently underdiagnosed, and strongly associated with adverse clinical outcomes. Meta-analytic data indicate that COPD is associated with more than a twofold increase in CKD prevalence, independent of shared risk factors such as age, smoking, hypertension, and diabetes. CKD in COPD is associated with increased mortality, exacerbation burden, and healthcare utilization. AKI represents a particularly severe expression of renal involvement, occurring most commonly during acute exacerbations of COPD (AECOPD). Although the reported incidence of AKI during AECOPD varies widely by clinical setting\u2014from approximately 2% in population-based studies to over 20% in hospitalized cohorts\u2014its presence is consistently associated with marked increases in mortality, respiratory failure, need for mechanical ventilation, and hospital length of stay. This review synthesizes current evidence supporting a lung\u2013kidney interorgan crosstalk framework in COPD, whereby chronic and acute pulmonary pathophysiology generates systemic disturbances that progressively impair renal structure and function. The heart is incorporated as a physiological intermediary, modulating hemodynamic transmission and venous congestion, without constituting the primary disease axis. Recognizing the role of kidney complications in COPD is crucial, as it influences how we diagnose, predict outcomes, and treat patients\u2014especially when there are sudden flare-ups.<\/jats:p>","DOI":"10.3390\/ijms27072996","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:05:33Z","timestamp":1774451133000},"page":"2996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Renal Dysfunction in Chronic Obstructive Pulmonary Disease Lung\u2013Kidney Interorgan Crosstalk with Cardiac Mediation"],"prefix":"10.3390","volume":"27","author":[{"given":"Robert","family":"Dragu","sequence":"first","affiliation":[{"name":"Internal Medicine C Department, Galilee Medical Center, P.O. Box 21, Nahariya 2210001, Israel"},{"name":"Pulmonary Vascular Diseases Service, Galilee Medical Center, Nahariya 2210001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2300239","DOI":"10.1183\/13993003.00239-2023","article-title":"Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary","volume":"61","author":"Celli","year":"2023","journal-title":"Eur. Respir. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.rmed.2011.10.004","article-title":"The Prevalence of Undiagnosed Renal Failure in a Cohort of COPD Patients in Western Norway","volume":"106","author":"Gjerde","year":"2012","journal-title":"Respir. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Gaddam, S., Gunukula, S.K., Lohr, J.W., and Arora, P. (2016). 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