Immediate Effect of Hemodialysis on Pulmonary Function and Bronchodilator Response in Patients with Chronic Renal Failure

Jeon, Ho Seok; Lee, Yang Deok; Cho, Yongseon; Han, Min Soo

Abstract

BACKGROUND: We hypothesized that there was a relationship between body weight change and bronchodilator response (BDR) in patients with chronic renal failure (CRF) on hemodialysis (HD). Several mechanisms such as pulmonary edema due to water retention or increased permeability of alveolar capillary may play a important role in pulmonary function impairment and bronchial hyperresponsiveness in patients with CRF on HD. But, no studies have been published concerning BDR in patients with CRF on HD. This study was aimed to know the immediate effect of hemodialysis on pulmonary function and BDR in patients with CRF on HD.
METHODS
This study included 30 patients with CRF on HD. We collected data including age, sex, height, pretibial and pedal pitting edema, interdialysis weight gain, postdialysis weight loss , underlying diseases, duration of HD, FEV1, FVC, FEV1/FVC, and BDR before and after HD.
RESULTS
Interdialysis weight gain of the patients was 3.4 +/- 1.0 kg, and postdialysis weight loss was 3.2 +/- 0.7 kg. Before HD, FEV1, FVC, and FEV1/FVC of the patients were 89 +/- 22%, 86 +/- 19% of predicted, and 87 +/- 10 %. After bronchodilator inhalation, these parameters were changed to 95 +/- 22%, 90 +/- 19% of predicted, and 88 +/- 9% respectively. BDR was positive in 15 patients. After HD, FEV1, FVC, and FEV1/FVC of the patients were 100 +/- 23%, 94 +/- 18% of predicted, and 88 +/- 11%. After bronchodilator inhalation, these parameters were changed to 102 +/- 23%, 96 +/- 18% of predicted, and 89 +/- 8% respectively. BDR was positive in 9 patients.
CONCLUSION
First, HD increases FEV1, FVC, and FEV1/FVC but little affects BDR. Second, there is no correlation between postdialysis weight loss and increases in FEV1, FVC, and FEV1/FVC after HD. Third, there is also no correlation not only between interdialysis weight gain and BDR before HD but between postdialysis weight loss and BDR after HD.