Bronchial Reactivity in Patients Undergoing Long-Term Haemodialysis for Chronic Renal Failure

Abstract

Trapping of neutrophils within the lung occurs in patients undergoing haemodialysis and is also a possible mechanism in the pathogenesis of bronchial hyper-responsiveness. Falls in peak expiratory flow rate occur in most dialysis patients, and some develop overt asthmatic symptoms. To see whether these changes in airway function are secondary to increases in bronchial reactivity during haemodialysis, we therefore performed histamine challenge testing in 6 non-asthmatic patients before and after haemodialysis. No change in reactivity was observed, suggesting that haemodialysis does not commonly result in bronchial hyper-reactivity in non-asthmatic individuals.

Acute effects of hemodialysis on lung function in patients with end-stage renal disease

“…Wu et al studied the PEF of patients undergoing hemodialysis with new cuprophane membranes manufactured by two different companies [24] and found a small reduction of the PEF during the first 45 minutes of dialysis with one of the membranes but no change in this parameter with the other membrane. Moreover, Walshaw et al [23] observed a small but sustained drop of less than 4% in peak flow (peak flow meter) after the start of the dialysis session using new cuprophane membranes in six long-term hemodialysis patients. These patients had stable chronic renal failure and underwent intermittent hemodialysis with no change in weight during the procedure.…”

“…It is unclear whether bioincompatibility of hemodialysis causes acute pulmonary dysfunction through the generation of inflammatory mediators with subsequent chronic lung disease. The few available clinical studies analyzing the effects of bioincompatible cuprophane hemodialysis membranes on pulmonary obstruction generated contradictory results [4,5,16,23,24], and there are theoretical concerns about the methods used to measure pulmonary function.…”

A panel of multiple markers associated with chronic systemic inflammation and the risk of atherogenesis is detectable in asthma and chronic obstructive pulmonary disease

“…Development of cardiovascular disease (CVD) has been reported in patients with asthma (5,6) and with COPD (7,8). In fact, both airway inflammatory disorders have also been known at increased risk for developing insulin resistance and type 2 diabetes (T2DM) (9), nephropathy (10), and even cancer (11). adhesion molecules, urinary microalbumin (uMA), and markers of oxidative and nitrosative stress, which have been identified to correspond to sequence of events of chronic inflammation (12), are detectable in chronic inflammatory lung diseases such as asthma and COPD.…”

Disorders of Respiration and Sleep-Disordered Breathing in Patients with Chronic Renal Failure

“…Even in CRF patients with reduced FEV 1 bronchial response to histanine or metacholine was normal and no change was observed with dialysis [20,21].…”