Effects of Hemodialysis and Renal Transplantation on Pulmonary Function

Zarday, Zoltan; Benjamin, James J.; Koerner, Spencer K.; Veith, Frank J.; Gliedman, Marvin L.; Soberman, Robert

doi:10.1378/chest.63.4.532

Cited by 15 publications

(7 citation statements)

References 4 publications

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“…There are very few reports on the effect of renal transplantation on the lung function. In a study on 7 renal transplant recipients [6], there was no significant change in lung function tests performed 2-3 weeks after transplantation. Another cross-sectional study on different groups of ESRF patients [5] showed that those who had undergone transplantation had significant ly reduced RV, but no other differences in lung volumes or diffusion were observed.…”

Section: Discussionmentioning

confidence: 90%

“…Despite the ad vances in dialysis technology permitting prolonged sur vival for uremic patients, pulmonary abnormalities like hyperemia, bronchitis, and interstitial fibrosis were com monly found at autopsy in chronic hemodialysis patients [2] . Renal transplantation, while correcting the metabolic disturbances of ESRF, predisposes the patients to addi tional hazards like infections, side effects of immunosup pressive agents, and immunologically induced damages [3] , Although renal transplantation is commonly prac ticed nowadays, there are very few studies on the conse quences of ESRF of pulmonary function [4,5] and their changes following transplantation [5,6]. We, therefore, carried out a longitudinal study on the lung functions in ESRF patients and their changes following renal trans plantation.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Renal Transplantation on Pulmonary Function in Patients with End-Stage Renal Failure

Chan¹,

Lai²,

Li³

et al. 1996

Am J Nephrol

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Ten patients with end-stage renal failure on maintenance dialysis underwent serial lung function tests before and at monthly intervals after renal transplantation. Mean values of forced expiratory volume within 1 s, forced vital capacity, and total lung capacity were within the normal range before and up to 6, months after transplantation. The mean value of residual volume (RV) was above the normal range during all periods measured (157.8 ± 21.5% predicted before transplantation and 121.2 ± 17.0% predicted at 6 months after transplantation). No statistically significant changes in lung volumes were detected over a course of 6 months, but there was a trend for a reduction in RV after transplantation. The single-breath diffusion capacity for carbon monoxide (DLCO) was in the high-normal range before transplantation (115.7 ± 9.5% predicted). It remained high at 1 month after transplantation (124.5 ± 12.2% predicted), but it gradually came down to the normal range from the 2nd month onwards. At 6 months after transplantation the mean DLCO was 83.8 ± 7.3% of predicted which was significantly (p < 0.0001) lower than the value before transplantation. We conclude that raised DLCO and RV values occurred in patients with end-stage renal failure on maintenance dialysis which were most likely the result of pulmonary vascular congestion, and these abnormalities tend to improve after renal transplantation.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Effect of Renal Transplantation on Pulmonary Function in Patients with End-Stage Renal Failure

Chan¹,

Lai²,

Li³

et al. 1996

Am J Nephrol

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“…However, in the majority of their patients lung involvement was secondary to causes other than renal failure. In a recent study of patients with end-stage renal disease, prepared for renal transplantation (but free of pulmonary disease and congestive heart failure), vital capacity and maximum voluntary ventilation were found to be within normal limits, although diffusing capacity of the lung was decreased, apparently due to anaemia (Zarday, Benjamin, Koerner, Veith, Gliedman & Soberman, 1973). No other lung function tests were performed.…”

Section: C Stgnescumentioning

confidence: 94%

Lung Function in Chronic Uraemia before and after Removal of Excess of Fluid by Haemodialysis

et al. 1974

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1. Measurements of lung volumes, airway resistance, maximal expiratory flow rates and closing volume were made in twelve patients with chronic renal insufficiency and fluid overload, before and after haemodialysis.2. Before dialysis, these measurements were within normal limits, except for peak expiratory flow rate, which was significantly lower, and closing volume, which was significantly higher than predicted values.3. After dialysis body weight decreased significantly and the removal of excess of fluid was accompanied by a significant decrease of closing volume.4. Measurements of closing volume and the other pulmonary tests were made in six healthy subjects, the same timing being observed as in the patients. Mean as well as individual values of closing volume did not alter, thus excluding the possibility that the changes observed in the patients were due to a circadian rhythm.5. It is suggested that the higher than predicted closing volume was due to the accumulation of fluid in the dependent areas of the lung, promoting a premature airway closure. Removal of excess of fluid allowed airways to close at a lower lung volume.

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“…Nevertheless, major derangements in pulmonary function tests are as a rule unusual in CRF without underlying cardiopulmonary disease or complications. In most patients, FEV 1 , VC and FEV 1 /FVC are within normal limits, although cases of a restrictive syndrome ormore rarely -of mild obstruction have also been reported [12][13][14][15][16]. VC can be more seriously affected if complications intervene (volume overload and incipient cardiac failure, extraosseus pulmonary calcification, pleural effusion, etc) [17].…”

Section: Lung Function In Patients With Chronic Renal Failurementioning

confidence: 99%

“…The most common abnormality in pulmonary function tests (PFTs) in patients with end-stage renal disease (ESRD) is a reduction in DLCO-sb that is seen in as many as 70% of dialyzed patients, often as an isolated finding, or coexisting with small airways disease [16,[22][23][24]. Changes in DLCOsb have been attributed to a reduction in the membrane component (Dm) with capillary blood volume (Vc) within normal limits [22,24].…”

Section: Lung Function In Patients With Chronic Renal Failurementioning

confidence: 99%

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

Μάρκου¹,

Αθανασίου²,

Hroni³

et al. 2006

CRMR

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Chronic renal failure may be associated with a wide spectrum of respiratory disorders, varying from relatively minor derangements in pulmonary function testing, to frank pulmonary edema. Although complications like uremic lung are becoming increasingly rare in these patients with timely initiation of dialysis, dialysis itself can also exert a transient deleterious influence on gas exchange. Moreover, patients with chronic renal failure often exhibit disorders of the chemical control of breathing that probably contribute to sleep-disordered breathing. Sleep -disordered breathing is a common problem in patients with chronic renal failure, with a reported prevalence possibly exceeding 70% for end-stage renal disease. Sleep disorders, have a serious impact in the quality of life in chronic renal failure, and are probably associated with increased morbidity and mortality. The role of polysomnography and of active intervention in sleep disorders in these patients needs to be further elucidated.

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Effects of Hemodialysis and Renal Transplantation on Pulmonary Function

Cited by 15 publications

References 4 publications

Effect of Renal Transplantation on Pulmonary Function in Patients with End-Stage Renal Failure

Effect of Renal Transplantation on Pulmonary Function in Patients with End-Stage Renal Failure

Lung Function in Chronic Uraemia before and after Removal of Excess of Fluid by Haemodialysis

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

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