Pulmonary Congestion and Edema in Uremia

DePass, Skottowe W.; Stein, Joseph; Poppel, Maxwell H.; Jacobson, Harold G.

doi:10.1001/jama.1956.02970180007002

Cited by 17 publications

(8 citation statements)

References 6 publications

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“…Clinical experience and evidence 62,86 supports the notion that a subset of patients with hypoxaemia or respiratory failure that requires mechanical ventilation seem to recover completely with fluid removal, suggesting that fluid overload leading to cardiogenic oedema was the primary cause of the respiratory failure in these patients. Other patients might recover somewhat with fluid removal but fail to be quickly extubated, and likely exhibit both cardiogenic and non-cardiogenic pulmonary oedema.…”

Section: Reviewsmentioning

confidence: 89%

“…As an example of this spirited debate, a report published in 1956 in the Journal of the American Medical Association opened with the statement, "The purpose of this paper is to deny the existence of the roentgenographic entity known as 'pulmonary azotemia' , 'uraemic lung' , or 'uraemic pneumonia'". 86 The authors of this paper seemed to consider that fluid overload alone was responsible for pulmonary oedema in AKI. Today, the accumulated evidence clearly suggests that either cardiogenic or non-cardiogenic pulmonary oedema can occur in AKI.…”

Section: Respiratory Complications In Akimentioning

confidence: 95%

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Mechanisms and mediators of lung injury after acute kidney injury

2015

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Acute kidney injury (AKI) is a common complication in hospitalized patients, associated with >50% mortality in those in intensive care who require renal replacement therapy. Data suggest that AKI is a systemic disease that adversely affects the immune system and organ function, and in this way contributes to the high mortality observed in affected patients. Data from patients and animal models indicate that AKI adversely affects the lungs. Respiratory complications are common in patients with AKI and include pulmonary oedema, respiratory failure requiring mechanical ventilation, prolonged duration of mechanical ventilation, and prolonged weaning from mechanical ventilation. The development of respiratory failure in patients with AKI greatly increases the risk of death. Data from animal models support the notion that cardiogenic pulmonary oedema (from volume overload) and non-cardiogenic pulmonary oedema (from endothelial injury due to inflammation and apoptosis) can occur in AKI. In this Review we discuss the clinical, epidemiologic, and animal data that provide insights into the mechanisms by which AKI can lead to lung injury and respiratory complications. Elucidation of the mechanisms of lung injury and respiratory complications after AKI is essential to develop effective therapies and reduce the high mortality associated with AKI and respiratory failure.

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Section: Reviewsmentioning

confidence: 89%

Section: Respiratory Complications In Akimentioning

confidence: 95%

Mechanisms and mediators of lung injury after acute kidney injury

2015

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“…These three factors favor edema formation independent of any specific lung defect. There is general 6,7 but not uniform 8 agreement that there are no specific radiologic features in edema caused by uremia, as against that of cardiac causes. However, there is evidence that abnormal capillary permeability is important in patients with uremia.…”

Section: Uremic Edema and Pneumonitismentioning

confidence: 95%

“…Even the existence of the specific entity "uremic pulmonary edema" has been denied. 6 The forces controlling water balance in the interstitium of the lung are microvascular and tissue, hydrostatic, and colloid osmotic pressures; the permeability of the microvasculature; and the flow in the lung lymphatics. Many of these are affected by renal failure.…”

Section: Uremic Edema and Pneumonitismentioning

confidence: 99%

The Lungs in Uremia

Bush¹

1988

Semin Respir Crit Care Med

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“…Causes of abnormal pulmonary function in patients with chronic renal failure (CRF) in clude fluid overload and/or congestive heart failure, uremic pneumonitis and/or pleuritis, muscle weakness, and pulmonary infection, fibrosis or calcification [5][6][7][8][9]. Based upon the above, it is apparent that patients with CRF associated with long standing SCI have two separate processes capable of causing pulmonary abnormali ties.…”

Section: Introductionmentioning

confidence: 99%

Frequency and Spectrum of Pulmonary Diseases in Patients with Chronic Renal Failure Associated with Spinal Cord Injury

Rd¹,

Nd²,

S³

1983

Respiration

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We reviewed autopsy records from 20 patients with long-standing spinal cord injury and chronic renal failure. Only 1 patient had normal pulmonary findings at autopsy. Acute and chronic pulmonary diseases were found in 16/20 and 17/20 patients, respectively. Pneumonia and fluid overload were the most common acute diseases. Interstitial and pleural fibrosis were the most common chronic diseases. However, a variety of illnesses including pulmonary amyloidosis, calcification, and arteriosclerosis were also found. Arterial blood gas studies indicated a high prevalence of hypoxemia. We concluded that significant pulmonary abnormalities are present in almost all spinal cord injury-chronic renal failure patients

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Pulmonary Congestion and Edema in Uremia

Cited by 17 publications

References 6 publications

Mechanisms and mediators of lung injury after acute kidney injury

Mechanisms and mediators of lung injury after acute kidney injury

The Lungs in Uremia

Frequency and Spectrum of Pulmonary Diseases in Patients with Chronic Renal Failure Associated with Spinal Cord Injury

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