[Pulmonary function in patients with chronic kidney failure]

Changes in the function of the respiratory system are among the frequent complications of chronic renal failure whereby their clinical impact is manifested above all in critically ill patients. A typical finding during ventilometric examinations is the limited airflow in the distal airways, and even the clinical picture of obstructive ventilation disorder is not rare. A reduced diffusion capacity of the lungs for CO was found in uraemic patients in long-term dialyzation program as well as after successful renal transplantation. The function of respiratory muscles is characterized by a reduction of the maximal inspiration and expiration pressure. Chronic haemodialyzed patients have a reduced ventilation response to CO2 which may render weaning from the ventilator difficult. In patients with chronic renal failure a high prevalence of the sleep apnoea syndrome was described. During haemodialysis we can observe alveolar hypoventilation, after its termination we find higher values of dynamic pulmonary volumes, as compared with values before dialysis. Chronic ambulatory peritoneal dialysis creates a prolonged state of iatrogenic ascites and this leads to a reduced residual functional capacity of the lungs, while the configuration of the diaphragm is altered. The author reviews in the submitted paper contemporary findings on the pathogenesis and clinical characteristics of pulmonary functions in patients with chronic renal failure.