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

Stănescu, Dan; Veriter, C.; Plaen, J. F. De; Frans, Albert; Strihou, Charles van Ypersele de; Brasseur, L.

doi:10.1042/cs0470143

Cited by 13 publications

(7 citation statements)

References 21 publications

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“…However, in early studies on small numbers of patients, removal of marked excess body water, i.e. up to 9.6% of body weight [26], resulted in significant improvement or normalization of decreased lung volume [17,21,26]. The weight gain in our patients was significantly less (1.2-4.4 kg or 2-6% of body weight) and all patients with irreversible restrictive lung function had a history of severe pulmonary disease or heart failure.…”

Section: Discussionmentioning

confidence: 63%

“…The intrasubject repeatability was less than 5%, which gives values low enough to detect significant responses to removal of excess water or biocompatibility-induced airway hyper-reactivity. Some studies investigating spirometric lung function in the dialysis population found no changes in VC, FEV1 and FEF25-75% before and at the end of a dialysis session using bioincompatible membranes [14,17,21], therefore it has been stated that in end-stage renal disease patients on hemodialysis lung volumes and flow rates are normal unless there is chronic pulmonary or chest-wall disease. However, in early studies on small numbers of patients, removal of marked excess body water, i.e.…”

Section: Discussionmentioning

confidence: 97%

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

Lang

Becker

Fischer

et al. 2006

Wien Klin Wochenschr

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 97%

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

Lang

Becker

Fischer

et al. 2006

Wien Klin Wochenschr

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“…Such patients often require prolonged ven tilatory assistance even after they achieve pulmonary function adequate for weaning (e.g., normalization of tidal volume, blood gas levels, or respiratory muscle competence). Both lung function per se and chemoregulation of ventilation are normal in most stable uremic subjects [6][7][8] and thus do not explain these findings.…”

mentioning

confidence: 42%

Respiratory Load Compensation in Uremia

Heinzmann¹,

Kassabian²,

Naqui³

et al. 1981

Respiration

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The clinical significance of respiratory-system load-compensation is unknown. We have measured the responses to random presentation of single, elastic inspiratory loads in 36 subjects: 8 normal personnel (N), 9 with obesity (O), 10 with chronic renal failure under hemodialysis (H), 5 with pneumonia (P), and 4 with interstitial lung disease (CILD). We have expressed these responses as: (1) the ratio of elastance (or rigidity) of the system during loaded breathing to the elastance without loading (E’_RS/E_RS); (2) the ratio of tidal volume (V_τ) achieved when breathing from an inspiratory load to the V_τpredicted in the absence of load compensation (V_TL/V_TP); (3) the ratio of inspiratory flow rates during loaded and unloaded breaths; (4) the ratio of inspiratory time of loaded and unloaded breaths. We found E’_RS/E_RS in the O₂ H and P groups less than that of either CILD patients or N controls (F = 6.79; p < 0.001). Passive elastance (E_Rg) although greater in groups·and H than in N (F = 3.88; p < 0.025) did not account for the difference in E’_RS in all groups. When expressed as V_TL/V_TP, the response to a 37-cm H₂O/1 load for groups H_,·and P was less than that for N (F = 5.51; p < 0.05). Diminished inspiratory time was observed in H_,·and P patients when inspiring from this load. In contrast, inspiratory flow did not differ from that of normal subjects. Nerve conduction velocity was slightly reduced or normal in the H patients. Respiratory load compensation is deficient in H_,·and P patients. The mechanism, which does not involve peripheral neuropathy, is unclear

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“…These changes in pulmonary function bore some resemblance to the abnormalities observed in patients with heart diseases in the present study and may suggest that early pulmonary congestion or oedema may cause an increase in dependent airway closure with increase in closing volume. A study of patients with chronic uraemia provides some support for this hypothesis (Stanescu, Veriter, Plaen, Frans, Strihou & Brasseur, 1974). Closing volume was increased above normal values in.the patients studied by Stanescu et al (1 974) and fluid removal by haemodialysis was accompanied by significant reduction in closing volume.…”

Section: Closing Volume and Fluid Overloadmentioning

confidence: 80%

Airway Function in Healthy Subjects and Patients with Left Heart Disease

1975

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1. In forty non-smoking healthy subjects and seventy-two patients with left heart diseases measurements were made of the volume expired in the first second of a forced expiration (FEV1) and the total volume expired in a forced expiration (FVC) before and after inhalation of salbutamol. Before and after salbutamol the healthy subjects and patients also inhaled maximally an inspirate, the first part of which contained 133Xe and, during controlled expiration, the radioactivity of the expirate was measured and plotted against its volume. the resulting curves were divided into phases of different slope by eye, the point at which phase 3 changed to phase 4 being nominated the closing volume. 2. In forty non-smoking healthy subjects inhalation of salbutamol was followed by significant increase in FEV1 but FVC and closing volume did not change. 3. Change in posture from seated erect to supine in thirty of these healthy subjects was accompanied by significant reduction in FEV1 and FVC and as closing volume was not significantly different in the two positions the ratio closing volume/vital capacity was increased with recumbency. 4. In seventy-two patients with left heart diseases without a history of cough or wheeze, FEV1, FVC, closing volume and the ratio closing volume/vital capacity were significantly different from values in the healthy subjects. There was no significant difference between non-smokers and ex-smokers amongst the patients. 5. Significant increase in FEV1, FVC and reduction in closing volume and the ratio closing volume/vital capacity followed inhalation of salbutamol in patients with heart diseases but the values remained significantly different from those recorded in the healthy subjects. 6. In twenty patients with heart diseases, FEV1 and FVC were reduced by change in posture from seated erect to supine but the ratio closing volume/vital capacity and the regression with age of this ratio were not significantly changed by change in position. 7. In patients with heart diseases the ratio closing volume/vital capacity was significantly correlated with severity of breathlessness and length of symptom-history but not with left ventricular end-diastolic or pulmonary vein wedge pressures.

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

Cited by 13 publications

References 21 publications

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

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

Respiratory Load Compensation in Uremia

Airway Function in Healthy Subjects and Patients with Left Heart Disease

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