Does Improvement in Respiratory Function after Hemodialysis Correlate with Ultrafiltration Volume?
DOI:
https://doi.org/10.51253/pafmj.v74i6.8002Keywords:
Hemodialysis, Spirometry, Ultrafiltration volume.Abstract
Objectives: To evaluate the effect of mechanical ultrafiltration on improvement in respiratory functions among patients of end-stage renal disease dependent on hemodialysis.
Study design: Cross-sectional analytical study.
Place and Duration of Study: Dialysis Unit, Combined Military Hospital Peshawar, Pakistan, from Sep to Nov 2021
Methodology: Patients on maintenance hemodialysis for at least three months were included. Patients with altered mental status and gross rheumatological abnormalities and unwilling patients were excluded. Spirometry was done before and after mid-week dialysis sessions thrice at two minutes intervals and the best values recorded. Different spirometry parameters before and after dialysis session were compared. The relationship of changes in these parameters with ultrafiltration volumes was also examined.
Results: A total of 50 patients were enrolled of which 36(72%) were females and 14(28%) were males. The mean age was 48.76±11.72 years. Low and high ultrafiltration groups included 26 and 24 patients, respectively. The median ultrafiltration volume was 1.5(1.00-2.80) liters. The majority of the patients showed restrictive pattern. The mean FEV1 percentage was 48.87±17.35 and 57.94±75.34 before and after hemodialysis respectively (p=0.387). The mean FVC percentage was 50.62±19.28 and 46.04±18.73 before and after the hemodialysis respectively (p=0.056). FEV1/FVC percentage was significantly different before and after hemodialysis i.e.106.7±24.0 and 113.30±16.94, respectively (p=0.014).
Conclusion: Lung parameters improved slightly in patients after dialysis. However, ultrafiltration volume did not have significant change on any of the measured parameters.
Downloads
References
Wen CP, Cheng TY, Tsai MK, Chang YC, Chan HT, Tsai SP, et al. All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan. Lancet 2008; 371(9631): 2173-2182.
Welch JL, Perkins SM, Johnson CS, Kraus MA. Patterns of interdialytic weight gain during the first year of hemodialysis. Nephrol Nurs J 2006; 33(5): 493-499.
Abdalla ME, AbdElgawad M, Alnahal A: Evaluation of pulmonary function in renal transplant recipients and chronic renal failure patients undergoing maintenance hemodialysis. Egypt J Chest Dis Tuberc 2013; 62: 145-150.
Campos I, Chan L, Zhang H, Deziel S, Vaughn C, Meyring-Wösten A, et al. Intradialytic Hypoxemia in Chronic Hemodialysis Patients. Blood Purif 2016; 41(1-3): 177-187.
https://doi.org/10.1159/000441271. Epub 2016 Jan 15
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(11): 907-912.
https://doi.org/10.1590/s1806-37132008001100004
Yuenyongchaiwat K, Vasinsarunkul P, Phongsukree P, Chaturattanachaiyaporn K, Tritanon O. Duration of hemodialysis associated with cardio-respiratory dysfunction and breathlessness: a multicenter study. PeerJ 2020; 8: e10333.
https://doi.org/10.7717/peerj.10333. eCollection 2020
Yılmaz S, Yildirim Y, Yilmaz Z, Kara AV, Taylan M, Demir M, et al. Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload. Med Sci Monit 2016; 22: 2779-2784.
https://doi.org/10.12659/msm.897480
Sharma A, Sharma A, Gahlot S, Prasher PK. A study of pulmonary function in end-stage renal disease patients on hemodialysis: a cross-sectional study. Sao Paulo Med J. 2017; 135(6): 568-572.
https://doi.org/10.1590/1516-3180.2017.0179150817
Anees M, Adhami SUZ, Aamer M, Shahid I. Pulmonary Functions in Patients with End Stage Renal Disease and their Effect after Hemodialysis. J Coll Physicians Surg Pak. 2021;31(2):144-149. https://doi.org/10.29271/jcpsp.2021.02.144
Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005; 26(2): 319-38.
Hasan M, Sutradhar I, Gupta RD, Sarker M. Prevalence of chronic kidney disease in South Asia: a systematic review. BMC Nephrol 2018; 19(1): 291.
https://doi.org/10.1186/s12882-018-1072-5
Hung SC, Kuo KL, Peng CH, Wu CH, Lien YC, Wang YC, et al. Volume overload correlates with cardiovascular risk factors in patients with chronic kidney disease. Kidney Int 2014; 85(3): 703-709. https://doi.org/10.1038/ki.2013.336. Epub 2013 Sep 11
Hung SC, Kuo KL, Peng CH, Wu CH, Wang YC, Tarng DC. Association of fluid retention with anemia and clinical outcomes among patients with chronic kidney disease. J Am Heart Assoc 2015; 4(1): e001480.
https://doi.org/10.1161/JAHA.114.001480
Mukai H, Ming P, Lindholm B, Heimbürger O, Barany P, Stenvinkel P, et al. Lung dysfunction and mortality in patients with chronic kidney disease. Kidney and Blood Pressure Research 2018; 43(2): 522-535.
https://doi.org/10.1159/000488699. Epub 2018 Mar 29
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(3): 214-7.
Hasan AM, Alashkar AM, Esmael NF, Ibrahim AAE. Assessment of pulmonary function in end stage renal disease patients on regular hemodialysis. Egypt J Hosp Med 2019; 76: 3319–3323.
Lang SM, Becker A, Fischer R, Huber RM, Schiffl H. Acute effects of hemodialysis on lung function in patients with end-stage renal disease. Wien Klin Wochenschr 2006; 118(3-4): 108-113. https://doi.org/ 10.1007/s00508-006-0564-7
Cury JL, Brunetto AF, Aydos RD. Negative effects of chronic kidney failure on lung function and functional capacity. Rev Bras Fisioter 2010; 14(2): 91-98.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Najmush Shakireen, Muhammad Amir, Abdul Rehman Arshad, Zain ul Abideen, Sobia Zaheer Ullah, Rabeea Ihtesham
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.