Pulmonary function in children with chronic renal failure.

Area of Science:

• Pediatric Nephrology
• Pulmonary Function Testing

Background:

• Chronic renal failure (CRF) can affect multiple organ systems, including pulmonary function in children.
• Previous studies have indicated potential respiratory complications in pediatric CRF patients, but comprehensive lung volume assessments are limited.

Purpose of the Study:

• To evaluate lung volumes, specifically vital capacity (VC) and forced expiratory volume in 1 second (FEV-1), in a cohort of children with chronic renal failure.
• To compare lung function across different stages of renal replacement therapy: conservative treatment (CT), hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD), and post-transplantation (TP).

Main Methods:

• Pulmonary function was assessed using spirometry to measure VC and FEV-1 in 45 children with CRF and 10 healthy controls.
• Residual volume (RV) was additionally measured in CAPD patients.
• Patients were stratified into CT, HD, CAPD, and TP groups.

Main Results:

• A significant proportion of CRF patients (38% for VC, 52% for FEV-1) exhibited lung volumes below predicted normal values (P < 0.05).
• Lung volumes were lowest in the CT group and highest in the TP group.
• Median FEV-1 was significantly reduced in CT (79%) and HD (82%) patients compared to predicted values (P < 0.05).
• FEV-1 showed a significant increase during hemodialysis sessions.

Conclusions:

• Lung volumes are frequently diminished in children with chronic renal failure.
• Pulmonary function parameters, including FEV-1, remain relatively stable during dialysis procedures (HD and CAPD).
• Lung function appears to improve following renal transplantation.