[Respiratory function abnormalities in uremic patients]

Patients with end-stage renal disease treated by hemodialysis are exposed to continuous pulmonary insults of multifactorial origin. Alterations in respiratory drive, mechanics, muscle function and gas exchange are frequent in hemodialysis patients. Pulmonary dysfunction may be the direct consequence of circulating uraemic toxins or may result indirectly from volume overload, anaemia, immune suppression, extraosseous calcification, malnutrition, electrolyte disorders, and/or acid-base imbalances. We have emphasised how derangement of diffusing capacity represents the most frequent and important respiratory abnormality in haemodialysed patients. It has been postulated that some forms of selective damage in the alveolo-capillary wall interferes with alveolar gas exchange.