Spirometric Parameters: Hemodialysis Compared to Peritoneal Dialysis

Document Type : Original Article

Authors

1 Pulmonologist, Lung Disease Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Ir

2 Nephrologist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Fellowship of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Iran

4 Resident of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Pulmonologist, Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Pulmonologist, Lung Disease Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction: Renal failure affects the mechanical and the ventilatory function of the lungs. A few studies have evaluated the ventilatory and pulmonary function in dialysis patients. The present study aimed to compare Pulmonary Function Test (PFT) results in patients undergoing Hemodialysis (HD) and Peritoneal Dialysis (PD).
Materials and Methods: We conducted a cross-sectional study on 50  patients with hemodialysis (HD) and 50 cases with PD who  underwent PFT in Ghaem and Imam Reza hospitals Mashhad, Iran from November 2010 to July 2012. Spirometric parameters including forced expiratory volume in 1s (FEV1), FEV1/forced vital capacity (FVC), forced expiratory flow 25-75% (FEF) and peak expiratory flow (PEF) were compared between the two groups of patients.
Results: Approximately 68% of the HD patients, 66% of the PD patients, and 67% of all the studied cases showed a normal spirometric pattern. Moreover, there were no significant differences between the two groups considering the mean of the aforementioned spirometric parameters(restrictive ,obstructive pattern) (P=0.969). However, an insignificant inverse correlation was observed between the duration of dialysis with FEV1 (r=0.381, P=0.008), FVC (r=-0.298, P=0.04), FEF 25-75% (r=0.43, P=0.003), PEF (r= 0.349, P=0.02) and FEV1/FVC (r=-0.363, P=0.01,) in the HD patients and between the patients’ age with FEV1/FVC (r=0.03, P=0.02) in the PD patients.
Conclusion: This study showed no significant difference in pulmonary function in hemo and peritoneal dialysis,so according this result ,both of the dialysis had the same affect on the lung function.

Keywords


  1. Brigham KL, Bernard G. Pulmonary complicationsof chronic renal failure. Sem Nephrol. 1981;1: 188–97.
  2. Senatore M1, Buemi M, Di Somma A, Sapio C, Gallo GC. Respiratory function abnormalities in uremic patients. G Ital Nefrol. 2004; 21:29-33.
  3. Lee YS. Ultrastructural observations of chronic uremiclungs with special reference to histochemical and X-raymicroanalytic studies on altered alveolocapillary basementmembranes. Am J Nephrol. 1985; 5:255-66.
  4. Vaziri ND, Toohey J, Paule P, Alikhani S, Hung E. Effectof hemodialysis on contact group of coagulation factors,platelets, and leukocytes. Am J Med. 1984;77;437-41.
  5. Sherlock JE, Yoon Y, Ledwith JW, Letteri JM. Respiratory gas exchange during hemodialysis. Proc Clin Dial Transplant Forum. 1972; 2:171-4.
  6. Aurigemma NM, Feldman NT, Gottlieb M, Ingram RH Jr, Lazarus JM, Lowrie EG. Arterial oxygenation during hemodialysis. N Engl J Med. 1977; 297: 871-3.
  7. Rackow EC, Fein IA, Sprung C, Grodman RS. Uremic pulmonary edema. Am J Med. 1978; 64:1084-8.
  8. Justrabo E, Genin R, Rifle G. Pulmonary metastatic calcification with respiratory insufficiency in patients on maintenance haemodialysis. Thorax. 1979; 34:384-8.
  9. Kovacević P, Stanetic M, Rajkovaca Z, Meyer FJ, Vukoja M. Changes in spirometry over time in uremic patients receiving long-term hemodialysis therapy. Pneumologia. 2011;60:36-9.
  10. Chan CH, Lai CK, Li PK, Leung CB, Ho AS, Lai KN. Effect of renal transplantation on pulmonary function in patients with end-stage renal failure. Am J Nephrol. 1996;16: 144–8.
  11. Wanic-Kossowska M. Immediate effect of hemodialysis with cuprophane membrane and acetate containing dialysis fluid on respiratory function in patients with chronic renal failure. Pol Tyg Lek. 1993; 48:175-7.
  12. Musacchio R, Senatore M, Bartoletti S. Effects of uraemia and its treatment on respiratory function. G Ital Nefrol. 2003; 20:69-70.
  13.  Rahgoshai R, Rahgoshai R, Khosraviani A, Nasiri AA, Solouki M. Acute effects of hemodialysis on pulmonary function in patients with end-stage renal disease. Iran J Kidney Dis. 2010; 4:214-7.
  14.  Bush A, Gabriel R. Pulmonary function in chronic renal failure: effects of dialysis and transplantation. Thorax.1991; 46:424-8.
  15. Herrero JA, Alvarez-Sala JL, Coronel F, Moratilla C, Gámez C, Sánchez-Alarcos JM, et al. Pulmonary diffusing capacity in chronic dialysis patients. Respir Med. 2002; 96:487-92.
  16. Kovelis D, Pitta F, Probst VS, Peres CP, Delfino VD, Mocelin AJ, et al. Pulmonary function and respiratory muscle strength in chronic renal failure patients on hemodialysis. J Bras Pneumol. 2008; 34:907-12.
  17.  Rezaeetalab F, Zeraati AA, Mostafania SH, Basiri B, M Lari SH.Renal fractional excretion of sodium in relation to arterial blood gas and spirometric parameters in chronic obstructive pulmonary disease. J Cardithorac Med. 2014; 2:147-51.