Pulmonary function tests and plasma nitric oxide levels in pediatric hemodialysis

The relationships between the lungs and the kidneys are clinically important; however, the impact of nitric oxide (NO) on respiratory function in renal patients is less known. The aim of this study is to evaluate pulmonary function tests (PFTs), NO level and their correlation in children on treatment with hemodialysis (HD) for the end-stage renal disease. This study was performed among 20 patients on regular HD and 20 controls. Participants were subjected to clinical examination, and pulmonary function evaluation was performed using spirometry. The following parameters were obtained as follows: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), Tüffenau index (FEV1/%FVC), (FEF25%-75%), and peak expiratory flow. Spirometry was carried out before and after HD sessions, and at the same time of clinical assessments, blood samples were taken to measure arterial-blood gas (ABG) and NO levels. There was the statistically significant difference between patient and control groups regarding NO and all PFTs except FEV1/FVC. There was no statistically significant correlation between NO and biological parameters in both cases and controls, but there was negative although the statistically not significant correlation between the PFTs, ABG, and duration of dialysis in the case group. There was statistically significant negative correlation between NO and some PFTs in case group; also the effect of dialysis on pulmonary functions tests and NO levels were only on the FVC of patients which significantly improved. Postdialysis blood gases remained normal among children on HD. NO may be involved in the deterioration of pulmonary function, and therefore, we feel that it can be used as a marker of clinical deterioration.