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Pulmonary diffusing capacity in chronic dialysis patients
J A Herrero1, J L Alvarez-Sala, F Coronel
1Department of Nephrology, Hospital Clínico San Carlos, Madrid, Spain. jaherrero@sensefro.org
Respiratory Medicine
|August 27, 2002
Summary
Long-term hemodialysis using bioincompatible membranes can cause reduced pulmonary diffusing capacity. This study found significant decreases in carbon monoxide transfer factor (TLCO) and KCO in patients on long-term dialysis, suggesting chronic pulmonary fibrosis.
Area of Science:
- Nephrology
- Pulmonology
- Biomaterials Science
Background:
- End-stage renal disease (ESRD) patients on hemodialysis face risks from bioincompatible membranes.
- Acute effects on lung microcirculation can lead to pulmonary fibrosis and diffusion defects with long-term dialysis.
Purpose of the Study:
- To investigate chronic pulmonary alterations in hemodialysis patients.
- To compare lung function in patients before dialysis, short-term dialysis, and long-term dialysis.
Main Methods:
- Studied 43 patients in three groups: pre-dialysis, <12 months dialysis, >5 years dialysis.
- Utilized first-use bioincompatible cellulosic dialysis membranes.
- Measured lung function parameters including FVC, FEV1, TLC, RV, TLCO, VA, KCO, and arterial blood gases.
Main Results:
- Long-term hemodialysis patients (>5 years) showed significantly lower TLCO and KCO.
- 75% of long-term dialysis patients had reduced TLCO or KCO compared to 17% pre-dialysis and 10% short-term.
Conclusions:
- Long-term hemodialysis with bioincompatible membranes is associated with reduced pulmonary diffusing capacity.
- Chronic pulmonary fibrosis is a likely cause of these observed pulmonary function changes.