Early Effects of Hemodialysis on Pulmonary Function in Patients with End-Stage Renal Disease

Abstract

Background: Renal failure may directly or indirectly influence pulmonary ventilation. Since hemodialysis can decrease the extra liquids, improvement in pulmonary function by decreasing liquids in the lungs is expected. Objectives: This study aimed to assess the effects of acute hemodialysis on spirometry parameters. Methods: A cross-sectional study was conducted among patients with end-stage renal disease who referred for hemodialysis to Ali Ibn Abitaleb Hospital of Zahedan City during 2016. Patient data including age, gender, and body mass index (BMI) were collected. Spirometry was performed one hour before and after hemodialysis, and spirometry parameters including vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, peak expiratory flow (PEF), forced expiratory flow between 25% and 75% FVC (FEF 25% - 75%) were measured. Results: A total number of 50 patients (30 men) completed spirometry. In men, there were a significant increase in FEV1 (mean difference = 0.217; P = 0.003) and FVC (0.298; P = 0.027) and a significant decrease in FEV1/FVC (-4.153; P = 0.038) after hemodialysis. In women, there was no significant change in the means of spirometry parameters. In addition, no significant relationship was found between PFT changes and BMI, weight change, or ultrafiltration volume. Conclusions: Our results showed that hemodialysis may improve pulmonary function tests in men. Studies with larger cohorts of patients are needed to derive valid effect estimates of hemodialysis on spirometry parameters with considering the role of chronic kidney diseases, various underlying diseases, different hemodialysis methods, and other related confounders.