Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis

Plesner, Louis Lind; Warming, Peder Emil; Nielsen, Toke Rammer; Dalsgaard, Morten; Schou, Morten; Høst, Ulla; Rydahl, Casper; Brandi, Lisbet; Køber, Lars; Vestbo, Jørgen; Iversen, Kasper

doi:10.1111/hdi.12342

Cited by 20 publications

(13 citation statements)

References 42 publications

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“…Additionally, there is growing literature about the prevalence of chronic obstructive pulmonary disease (COPD) in patients with CKD (11,12). Notwithstanding etiology, hypoxemia and hypoxia are associated with a host of acute and chronic sequelae affecting multiple organ systems (13)(14)(15), including the cardiovascular system (16,17), wound healing (18), proinflammatory pathways (19), and the central nervous system (20).…”

Section: Introductionmentioning

confidence: 99%

Intradialytic Hypoxemia and Clinical Outcomes in Patients on Hemodialysis

Meyring-Wösten

Zhang

et al. 2016

Clinical Journal of the American Society of Nephrology

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Background and objectives Intradialytic hypoxemia has been recognized for decades, but its associations with outcomes have not yet been assessed in a large patient cohort.Design, setting, participants, & measurements Our retrospective cohort study was conducted between January of 2012 and January of 2015. We recorded blood oxygen saturation every minute during hemodialysis in patients with arteriovenous access. A 6-month baseline period with at least 10 treatments with oxygen saturation measurements preceded a 12-month follow-up. Patients were stratified by the presence or absence of prolonged intradialytic hypoxemia defined as oxygen saturation ,90% for at least one third of the treatment time. Demographic, laboratory, and treatment data and hospitalization and mortality rates were compared between the groups. Multivariate Cox regression analysis was used to assess baseline predictors of all-cause mortality during follow-up.Results In total, 100 (10%) of 983 patients had prolonged intradialytic hypoxemia. These patients were older (+3.6 years; 95% confidence interval, 0.8 to 6.3), had longer dialysis vintage (+1.2 years; 95% confidence interval, 0.3 to 2.1), and had higher prevalence of congestive heart failure (+10.8%; 95% confidence interval, 1.6 to 20.7) and chronic obstructive pulmonary disease (+13%; 95% confidence interval, 5 to 21.2). They also resembled an inflammatory phenotype, with lower serum albumin levels (20.1 g/dl; 95% confidence interval, 20.2 to 0) and higher neutrophil-to-lymphocyte ratios (+1; 95% confidence interval, 0.5 to 1.6). They had lower hemoglobin levels (20.2 g/dl; 95% confidence interval, 20.4 to 0) and required more erythropoietin (+1374 U per hemodialysis treatment; 95% confidence interval, 343 to 2405). During follow-up, all-cause hospitalization (1113 hospitalizations; univariate hazard ratio, 1.46; 95% confidence interval, 1.22 to 1.73) and mortality (89 deaths; adjusted hazard ratio, 1.98; 95% confidence interval, 1.14 to 3.43) were higher in patients with prolonged intradialytic hypoxemia.Conclusions Prolonged intradialytic hypoxemia was associated with laboratory indicators of inflammation, higher erythropoietin requirements, and higher all-cause hospitalization and mortality.

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Section: Introductionmentioning

confidence: 99%

Intradialytic Hypoxemia and Clinical Outcomes in Patients on Hemodialysis

Meyring-Wösten

Zhang

et al. 2016

Clinical Journal of the American Society of Nephrology

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“…Plesner et al (26) examined changes in spirometry parameters in COPD patients undergoing dialysis in 2016 and found that improvement in the FEV1/FVC ratio and FEV1 was significantly related to patients' ultra-filtrated volume; furthermore, when this volume was more than 0.3 of the body weight, a significant improvement in the FEV1/FVC ratio and FEV1 was seen. This is while in our study, there was no relationship between ultra-filtrated volume and spirometry parameters.…”

Section: Discussionmentioning

confidence: 99%

“…Renal disease and renal failure are two leading causes of the global burden of diseases and important causes of death in developing countries. Chronic kidney disease (CKD) is considered one of the main global health issues due to its high prevalence, progression to end-stage renal disease (ESRD), and early death (1)(2)(3)(4). CKD emanates from various renal damages and is an irreversible, progressive disease that may progress gradually and lead to the loss of renal function and ESRD (5).…”

Section: Introductionmentioning

confidence: 99%

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

Momeni

Shahraki

Yarmohammadi

et al. 2020

Zahedan J Res Med Sci

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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.

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“…Finally, the effects of hemodialysis in COPD patients with end‐stage renal disease also deserve to be mentioned. Although dyspnea is frequently observed among patients on hemodialysis, respiratory causes of dyspnea often remain unrecognized . On average, hemodialysis does not increase forced vital capacity and FEV 1 among COPD patients unless a critical threshold of fluid removal, likely at least 3% of bodyweight, is achieved .…”

Section: Ckd In Patients With Copd: Clinical and Prognostic Relevancementioning

confidence: 99%

“…Although dyspnea is frequently observed among patients on hemodialysis, respiratory causes of dyspnea often remain unrecognized . On average, hemodialysis does not increase forced vital capacity and FEV 1 among COPD patients unless a critical threshold of fluid removal, likely at least 3% of bodyweight, is achieved . Accordingly, close cooperation between pulmonologists and nephrologists is highly desirable for the optimal management of these complex patients.…”

Section: Ckd In Patients With Copd: Clinical and Prognostic Relevancementioning

confidence: 99%

Chronic kidney disease: A likely underestimated component of multimorbidity in older patients with chronic obstructive pulmonary disease

Corsonello

Aucella

Pedone

et al. 2017

Geriatrics Gerontology Int

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The coexistence of chronic kidney disease and chronic obstructive pulmonary disease, two age-related conditions, has important clinical and prognostic implications. Respiratory failure is associated with important changes in glomerular and tubulointerstitial function. In contrast, renal failure can affect lung function, mainly by adding a restrictive component or causing complications, such as uremic pulmonary edema and pleural effusion. The effect of age on renal and pulmonary function adds to the complexity of the interplay between the kidney and the lung in these patients. Chronic kidney disease also represents an important risk factor for adverse drug reactions in older chronic obstructive pulmonary disease patients in which multimorbidity and polypharmacy are highly prevalent. Finally, an additive effect of chronic kidney disease and chronic obstructive pulmonary disease might also contribute to the pathophysiology of sarcopenia. Nevertheless, several gaps in our knowledge of the lung-kidney interplay still exist, thus suggesting further basic and clinical research on this topic. Geriatr Gerontol Int 2017; 17: 1770-1788.

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Chronic obstructive pulmonary disease in patients with end‐stage kidney disease on hemodialysis

Cited by 20 publications

References 42 publications

Intradialytic Hypoxemia and Clinical Outcomes in Patients on Hemodialysis

Intradialytic Hypoxemia and Clinical Outcomes in Patients on Hemodialysis

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

Chronic kidney disease: A likely underestimated component of multimorbidity in older patients with chronic obstructive pulmonary disease

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