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The effect of renal transplantation on pulmonary function
Betül Kalender1, Müzeyyen Erk, Meltem Ayaz Pekpak
1Department of Nephrology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey. bkalender@hotmail.com
Nephron
|December 18, 2001
Summary
Chronic renal failure patients, even without symptoms, exhibit impaired pulmonary diffusion capacity. Kidney transplant recipients also show functional abnormalities, indicating persistent lung issues post-transplant.
Area of Science:
- Nephrology
- Pulmonology
- Transplantation Medicine
Background:
- Chronic renal failure (CRF) can lead to subclinical pulmonary changes and functional disorders.
- Uremia is associated with alveolocapillary defects, impacting lung function.
- Assessing pulmonary function in CRF and post-transplant patients is crucial for understanding long-term health.
Purpose of the Study:
- To determine pulmonary functional disorders, particularly alveolocapillary defects, in renal transplanted patients.
- To compare pulmonary function and diffusion capacity between non-dialyzed uremic patients and successfully transplanted patients.
- To identify the prevalence of pulmonary abnormalities in both groups, irrespective of symptoms.
Main Methods:
- Pulmonary function tests including forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF25-75) were measured.
- Single breath carbon monoxide diffusion tests were performed to assess diffusion lung capacity adjusted for hemoglobin concentration (DLAdj).
- Uremic patients (n=20) and renal transplant recipients (n=20) without pulmonary symptoms were randomly selected and assessed.
Main Results:
- Nondialyzed uremic patients showed normal mean spirometric values but slightly reduced PEF25-75 and DLAdj, with 18/20 exhibiting functional abnormalities.
- Transplanted patients had normal mean spirometric parameters and diffusion capacities, but 13/20 had functional abnormalities.
- Significant differences in spirometric values (except FVC) and diffusion capacities were observed between the uremic and transplanted groups.
Conclusions:
- Uremic patients exhibit disturbed pulmonary function, especially diffusion capacity, even without overt symptoms.
- While mean pulmonary function tests are normal in transplanted patients, a significant proportion still present with functional deficits.
- These findings highlight the persistent impact of renal disease and transplantation on lung function, necessitating continued monitoring.