The Lungs in Uraemia: A Review

Bush, Andrew; Gabriel, Roger

doi:10.1177/014107688507801012

Cited by 28 publications

(22 citation statements)

References 46 publications

(33 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The fluid overload between HD sessions and abnormal permeability of the pulmonary microcirculation have been cited as causes of acute pulmonary edema (noncardiogenic) and pleural effusion (28) that can reduce volumes and lung capacity over time. This respiratory complication changes the ventilation/perfusion relationship (with or without the presence of anemia), reduces gas exchange, tissue oxygenation, and, consequently, functional capacity (activities of daily living) and exercise tolerance (29)(30)(31) .…”

Section: Discussionmentioning

confidence: 99%

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Soares¹,

Oliveira‐Silva²,

Silva³

et al. 2020

mtprehabjournal

View full text Add to dashboard Cite

Background: Patients undergone hemodialysis (HD) suffer with energy-protein malnutrition, uremic myopathy and protein catabolism reducing their functional capacity, tolerance to exercise and aspects related to quality of life. Objective: The aim of this study was to evaluate the effects of the two protocols of inspiratory muscle training (IMT) on muscle strength, pulmonary function and related-health quality of life on male HD patients. Methods: Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), peak expiratory flow (PEF), forced expiratory volume in first second (FEV 1 ), forced vital capacity (FVC) and the FEV 1 /FVC ratio and quality of life were evaluated pre and post six months of IMT in HD patients. IMT was performed by one group using a specific training (Power breathe) device (T-IMT, n=19) and by the other with incentive spirometry (I-IMT, n= 15). Results: Following the inspiratory training, muscle strength improved in both groups. The group that used incentive spirometry had increments in MIP larger (39.8%, p<0.001) than the group that trained with the specific training device (28.3%, p=0.001). The KDQOL-SF dimensions showed significant difference in the T-IMT group in cognitive function (p=0.03), sexual function (p=0.009) and social function dimensions (p=0.04) and in the I-IMT group in the physical function dimension (p=0.03). Conclusion: It was proved that IMT improved muscle strength and I-IMT promoted increments significantly larger in MIP. Aspects of health-related quality of life of HD male patients improved significantly with T-IMT (sexual, social and cognitive functions), while I-IMT ameliorated only physical function.

show abstract

Section: Discussionmentioning

confidence: 99%

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Soares¹,

Oliveira‐Silva²,

Silva³

et al. 2020

mtprehabjournal

View full text Add to dashboard Cite

show abstract

“…Common expressions of the uraemic lung are pulmonary oedema, fibrosis, pulmonary hypertension, haemosiderosis and pleural effusion [1][2][3][4]. Patients with chronic renal failure are often treated with continuous ambulatory peritoneal dialysis (CAPD) [5].…”

mentioning

confidence: 99%

Respiratory muscle strength during continuous ambulatory peritoneal dialysis (CAPD)

Siafakas

Argyrakopoulos²,

Andreopoulos³

et al. 1995

Eur Respir J

View full text Add to dashboard Cite

R Re es sp pi ir ra at to or ry y m mu us sc cl le e s st tr re en ng gt th h d du ur ri in ng g c co on nt ti in nu uo ou us s a am mb bu ul la at to or ry y p pe er ri it to on ne ea al l d di ia al ly ys si is s ( (C CA AP PD D) ) N Maximum pressures, spirometry and lung volumes were measured before dialysis, 4 h after the administration of 2 l of dialysate into the peritoneal cavity, and just after the next drainage. In addition, biochemical indices (urea, creatinine, sodium, potassium, calcium and phosphorus) and haematological indices (haemoglobin (Hb) and haematocrit (Hct)) were measured once before the treatment.The results showed that mean PImax and PEmax were normal, with a very wide range between patients, before CAPD. However, seven patients (27%) showed a PImax of <75% predicted (pred) and eight (31%) a PEmax <75% pred. Maximal pressures decreased significantly during CAPD and increased again after the drainage of fluid. Similarly, lung volumes were within the normal range before and decreased significantly during CAPD. The forced expiratory volume in one second to forced vital capacity (FEV 1 /FVC) ratio did not change.We conclude that respiratory muscle strength was preserved in the majority of the patients with chronic renal failure treated with CAPD. During CAPD, lung volumes and respiratory muscle function were decreased, demonstrating an effect of the abdominal cavity on the mechanics of the respiratory system. However, the decrease in the maximum pressures was less than 20%, indicating that CAPD is a safe procedure in patients without pre-existing pulmonary disease or uraemic pulmonary complications. Respiratory muscle strength increased immediately after the drainage of fluid.

show abstract

“…The lungs may be severely affected by advanced chronic kidney disease (CKD) [3]; however, the prevalence of lung dysfunction is increased even in patients with CKD stage 1-4, to 10% for restrictive and 16% for obstructive lung function according to the National Health and Nutrition Examination Survey (NHANES) 2007-2012 [4]. As glomerular filtration rate (GFR) falls, pulmonary edema and respiratory muscle dysfunction become more common due to fluid retention and metabolic, endocrine and cardiovascular alterations [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Lung Dysfunction and Mortality in Patients with Chronic Kidney Disease

Mukai

Pei

Lindholm

et al. 2018

Kidney Blood Press Res

View full text Add to dashboard Cite

Background/Aims: Lung dysfunction associates with increased mortality but the impact of chronic kidney disease (CKD) is less clear. We evaluated lung function and its association with mortality among individuals with normal to severely reduced glomerular filtration rate (GFR). Methods: 404 individuals representing GFR category G1 (n=31; GFR >90 mL/min/1.73 m²), G2 (n=46), G3 (n=33), G4 (n=49) and G5 (n=245; GFR< 15 mL/min/1.73 m²) underwent spirometry yielding lung function indices forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁) and peak expiratory flow (PEF). Associations of lung function indices expressed as percentages of predicted values (%FEV₁, %FVC and %PEF) with 5-year mortality were analyzed by competing-risk regression models. Results: The prevalence of obstructive (6% in G1 and 11% in G5) and especially restrictive (9% in G1 to 36% in G5) lung dysfunction increased with declining GFR and with higher comorbidity burden. In patients (n=22) with protein-energy wasting, inflammation and cardiovascular disease, the prevalence of restrictive lung function was 64%. The highest tertiles of % FEV₁ and %FVC associated with lower sub-hazard ratios (sHR) for all-cause mortality, 0.49 (95% CI, 0.27-0.88)) and 0.56 (95% CI, 0.32-0.98), and that of %FEV₁ also with lower cardiovascular mortality risk (sHR 0.16; 95%CI 0.04-0.69) after adjusting for multiple confounders. Restrictive lung dysfunction (FEV₁/FVC ≥ 0.70, and %FVC < 80) associated with increased mortality risk (sHR 1.80, 95%CI, 1.04-3.13) while the association with obstructive lung impairment was not statistically significant. Conclusion: Lung dysfunction and in particular restrictive lung dysfunction associates with degree of renal function impairment and presence of comorbidities, and is an independent predictor of increased mortality in CKD patients.

show abstract

The Lungs in Uraemia: A Review

Cited by 28 publications

References 46 publications

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Inspiratory muscle training improves strength and health-related quality of life in hemodialysis patients

Respiratory muscle strength during continuous ambulatory peritoneal dialysis (CAPD)

Lung Dysfunction and Mortality in Patients with Chronic Kidney Disease

Contact Info

Product

Resources

About