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Another Connection I Hadn’t Expected 

Another Connection I Hadn’t Expected 

Wow, Christmas and Chanukah are over. Kwanzaa is today, as is Boxing Day. I know there are other holidays in December, too. I hope each one was [is] good to you. Unfortunately, that isn’t true for my husband. He may have pneumonia. 

Bear also vacillates between stage 2 and stage 3 chronic kidney disease. That, of course, got me to thinking. If he does have pneumonia, will it affect his ckd? Or did the ckd have something to do with his possibly developing pneumonia? 

According to the National Heart, Lung, and Blood Institute

“Pneumonia is an infection that affects one or both lungs. It causes the air sacs, or alveoli, of the lungs to fill up with fluid or pus. Bacteria, viruses, or fungi may cause pneumonia. Symptoms can range from mild to serious and may include a cough with or without mucus (a slimy substance), fever, chills, and trouble breathing. How serious your pneumonia is depends on your age, your overall health, and what caused your infection.” 

Well, he’s older than I am and I’m 75, so if it is pneumonia, it could be serious. Bear is now on his second round of antibiotics, just in case it is bacterial. But wait a minute. We’re trying to figure out if pneumonia and ckd are in some way connected, not if my husband is in any trouble here.   

I took a chance and turned to the National Center for Biotechnology Information to find out since they often have helped me with information I needed. 

“Infections are a major cause of morbidity and mortality in chronic kidney disease (CKD) patients. The relationship is mutual: not only infections are [sic] severe and difficult to manage in CKD, but infections also contribute to the progression of CKD and complicate its management…. Lower respiratory tract infections e.g. Pneumonia are common occurrences in CKD patients and are associated with increased risk of hospitalization, cardiovascular events and mortality… 

CKD has long been considered an independent risk factor for pneumonia. The risk of pneumonia is up to 1.97 fold higher in CKD patients-1.4 times higher for outpatient pneumonia and even higher, i.e., 2.17 times for inpatient pneumonia compared with patients without CKD….” 

By the way, the previous source is part of the National Library of Medicine which, in turn, is part of the National Institutes of Health. The first source is also part of the National Institutes of Health. 

Let’s look at this a little bit more closely. Most importantly, there is a connection between pneumonia and ckd. 

Side note, I’ve had a lower respiratory infection. No one mentioned it was pneumonia. I wonder why? I’m certain I reported to the doctor that I had CKD. I always do. How did I not know about this? It is amazing to me that after 11 years of blogging about ckd, I’m still learning about it. 

Back to pneumonia. Let’s see if we can root out something about the mechanism. I had to really dig for some answers. Several explanations were too medicalese for me; I just didn’t understand them. Others talked only about acute kidney injury [AKI]. Yet others dealt more with only end stage kidney disease [ESRD]. I finally settled upon American Journal of Physiology-Lung Cellular and Molecular Physiology for this information: 

“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.” 

Oh my, Doctors Health Press informs us that unbalanced Ph can affect: 

“Circulatory system…. 

Digestive system…. 

Urinary system…. 

Immune system…. 

Integumentary system…. 

Muscular system…. 

Nervous system…. 

Reproductive system…. 

Respiratory system…. 

Skeletal system….” 

Did you notice the respiratory system? That includes the lungs.  

Keeping in mind that phosphate helps filter waste from the kidneys, what does it have to do with the lungs and pneumonia? Here’s Springer Link’s explanation: 

“For a long time, phosphate, the anion [Gail here: that’s a negatively charged ion] that incorporates the element phosphorus, has been considered of minor relevance compared to its most studied parent calcium. However, the interest in phosphate metabolism has been remarkably increased in the last two decades. This has been mainly driven, among others, by two factors. The first one relates to the appreciation that hypophosphatemia (as well as hyperphosphatemia), has deleterious effects not only on bone but also on other organs and systems such as skeletal muscle, myocardium, the haematopoietic, respiratory and central nervous systems, in addition to sensory organs …. Further impetus has been fuelled by finding molecular mechanisms underlying congenital diseases characterized by hypo and hyperphosphatemia and discovery of drugs reversing the culprit mechanism.” 

Remember that hypo means low and hyper means high. Also, phosphatemia means of or about phosphate. I was hoping you would notice ‘respiratory’ included above. 

As for the immune system, Nature Views Immunology states, 

“The kidney has a central role in electrolyte homeostasis and the removal of toxins and so, when its function is compromised, normal immune effector cell function and intestinal microbial homeostasis are disturbed.” 

A different journal, Nature Immunology, offers the following: 

“Of all the sites of the body subject to incursion by pathogens, the lungs represent the most challenging immunological dilemma for the host. Not only do the lungs represent the environment most frequently targeted by pathogens, their role as the organ of gas exchange makes their normal functioning critical for health and intolerant of collateral damage.” 

Uh-oh, so it is possible for pneumonia and ckd to not only be associated, but each can worsen the other. Not what I was hoping to find, but information that will be helpful in treating my husband’s two illnesses. 

Until next year, 

Keep living your life! 

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