Pulmonary complications of renal disorders

To manage patients with diseases of the lungs and the kidneys, one must first understand the relationship between respiratory and renal function. In treating acute renal failure (ARF), the clinician often must contend with respiratory manifestations of volume overload and metabolic acidosis. Mechanical ventilation in patients with renal failure (RF) can be challenging, particularly with lung protective ventilation and weaning. Patients with chronic renal failure (CRF) experience several respiratory complications. Hypoxaemia during dialysis is now understood to be a predictable effect of the loss of CO(2) into the dialysate. Critical illness of any primary cause predisposes patients not only to acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) but also to the development of ARF. Meanwhile, the potential for ventilator-induced renal injury has increasingly become the subject of active investigation.