Abstract:
Chronic obstructive pulmonary disease (COPD) is a multifactorial condition
characterized not only by damage to the respiratory system but also by pronounced systemic
manifestations, including endothelial dysfunction, oxidative stress, and comorbidities.
Cardiovascular and renal complications, driven by shared pathogenetic mechanisms such as
chronic inflammation, hypoxia, and microcirculatory disorders, have the greatest clinical
significance. This review presents current insights into the pathogenesis of COPD in the context
of comorbidity, with an emphasis on the role of systemic inflammation, endothelial dysfunction,
and activation of free radical processes. Both pharmacological and non-pharmacological
treatment approaches are discussed, including bronchodilators, inhaled corticosteroids,
phosphodiesterase-4 inhibitors, antioxidants, antihypoxants, as well as risk factor modification
measures and pulmonary rehabilitation. Special attention is given to the interplay between COPD
and chronic kidney disease, as well as the prospects for combined therapeutic strategies aimed at
correcting systemic disorders and improving patient outcomes. The presented data highlight the
need for a comprehensive approach to COPD management, taking into account the individual
course of the disease and associated comorbidities
