Ventilator Function Improvement in Patients Undergoing Regular Hemodialysis: Relation to Sex Differences

Abstract

Uremic lung is different entity then oedema present in cardiovascular diseases or in adult respiratory distress syndrome as well. This state is one of the possible complications in patients with chronic renal failure (CRF) receiving regular hemodialysis (HD). There are several studies suggesting that in these patients in 30-40% cases pulmonary hypertension was developed. It is known that patients with primary pulmonary hypertension have peripheral airway obstruction The data also showed that primary as well secondary pulmonary hypertension are more often developed in females; even real reason is still unknown. The aim of the study was to estimate the ventilator function improvement in patients with CRF receiving regular HD related to sex differences. The study population consisted in 39 patients with CRF, with no cardiac and pulmonary diseases. These patients were treated by regular hemodialysis using bicarbonate or acetate mode, respectively. They were divided into two groups according to the sex. Spirometry parameters before and after onset of hemodialysis were recorded. The results were analyzed using Student t-test and presented as mean +/-SD. All p values <0,05 were considered significant. The result showed that ventilatory function in male patients is significantly improved, especially VC and FEV1, whereas in female patients improvement had not statistical significance. It can be concluded that one of the possible reasons for slight improvement of ventilator function in female patients is pulmonary hypertension.

Effects of Interdialytic Weight Gain on Lung Function Tests in Hemodialyzed Patients

“…In group 1, after haemodialysis, FEV1 value is highly improved (p<0.01), while in group 2 (with greater interdialysis gain) FEV1 is recovered, but without statistical significance (p>0.05). Results of other studies conducted on patients suffering from uraemia, show significant FEV1 recovery after haemodialysis, which is similar to our findings [7][8][9][10][11][12][13]. Positive effect of haemodialysis on FEV1 is more expressed in group 1 (patients with interdialysis liquid gain < 5%) than in group 2 (patients with interdialysis liquid gain > 5%).…”

“…FEV1 before haemodialysis in patients with lower interdialysis intake (group 1) are significantly lower (p<0.05) compared to the stated values in patients with greater interdialysis intake (group 2). The reason for these findings might be found in difference in heamodialysis duration, sex, age, and some other antropometric parameters (height and weight) that influence vital capacity values [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

“…Effects of chronic haemodialysis and especially interdialytic weight gain of water on respiratory function along with its complications are less known [4][5][6][7][8][9]. Literature data on this topic are insufficient and contradictory.…”

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

“…These results tie in with several studies showing a reduction in respiratory muscle strength and changes in lung function of patients on HD compared with the predicted values for age or healthy subjects (22)(23)(24) . Other studies have evaluated the acute effects of HD on strength and lung function and showed that the weight gained between dialysis sessions has deleterious effects on respiratory function (25,26) .…”

The correlation between endothelin-1 levels and spirometry in dialysis patients compared to healthy subjects

“…The negative effects of uremia are also present in the lungs. The ventilatory function disorder in this group of patients is mainly presented as an obstructive pulmonary disease [1][2][3]. Apart from these findings, a number of medical journals provides data stating the existence of a vasoactive molecule imbalance in uremic patients, primarily endothelin-1 (ET-1) [4][5][6][7][8][9][10][11].…”