Pathogenetic Mechanisms of the Bi-directional Interrelationship Between the Respiratory and Urinary Systems

The relationship between the lungs and kidneys is one of the key fundamental and clinical problems in modern medicine. The high prevalence of respiratory and urinary diseases, their frequent co-occurrence in a single patient, and the presence of common pathogenetic mechanisms (systemic inflammation, hypoxia, oxidative stress, activation of the renin-angiotensin-aldosterone system with hemodynamic changes) necessitate an in-depth study of interorgan interactions. Understanding the bidirectional influence of lung pathology on the kidneys and vice versa is the basis for timely diagnosis, prevention of complications in comorbid conditions, and the development of comprehensive treatment strategies, thereby improving the prognosis and quality of life for this category of patients. The lungs and kidneys share profound structural and functional parallels, determining their close pathophysiological interaction. This paper examines research data on common and specific pathogenetic mechanisms, as well as clinical data reflecting the impact of bronchopulmonary diseases on renal function and, conversely, the impact of urinary tract diseases on lung health. It has been established that bronchopulmonary diseases, through hypoxia, chronic systemic inflammation, and oxidative stress, contribute to the development and progression of renal dysfunction, including albuminuria and a decrease in glomerular filtration rate. The aim of this review article is to summarize current understanding of the bidirectional anatomical, functional, and pathophysiological relationships between the lungs and kidneys, with an emphasis on the mutual influence of chronic diseases of these systems and their clinical significance. The findings highlight the need for a comprehensive, interdisciplinary approach to the diagnosis, monitoring, and treatment of patients with both respiratory and urinary tract diseases to improve long-term outcomes.