Pulmonary function and respiratory muscle strength in chronic renal failure patients on hemodialysis.
OBJECTIVE
To evaluate pulmonary function and respiratory muscle strength in chronic renal failure patients, correlating these variables with hemodialysis-related weight fluctuation; to study the correlation between the duration hemodialysis and potential respiratory alterations.


METHODS
Seventeen patients (median age, 47 years; interquartile range, 41-52 years), submitted to three weekly hemodialysis sessions for a median of 27 months (interquartile range, 14-55) were evaluated. Twelve of the patients were male. The patients underwent spirometry. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured prior to and after the first hemodialysis session of the week. Body weight was quantified prior to and after each of the three weekly sessions.


RESULTS
Before the first hemodialysis session of the week, 8 patients presented mild restrictive defect, which normalized after the session in 2 of those patients. After dialysis, there was a significant increase in forced vital capacity (p = 0.02) and a significant decrease in body weight (p = 0.0001). Weight fluctuation over 3 days without hemodialysis tended to correlate with the variation in forced vital capacity in the first weekly session (r = 0.47; p = 0.055). Duration of hemodialysis correlated with predialysis MIP (r = -0.3; p = 0.03) and MEP (r = -0.63; p = 0.006).


CONCLUSIONS
More pronounced weight gain in the interdialytic period is associated with worsening of lung function, which is almost fully reversible by hemodialysis. In addition, longer duration of hemodialysis is associated with decreased respiratory muscle strength.
Kovelis
Demetria
D
Departamento de Fisioterapia, Universidade Estadual de Londrina. dkovelis@yahoo.com.br
Pitta
Fábio
F
Probst
Vanessa Suziane
VS
Peres
Celeide Pinto Aguiar
CP
Delfino
Vinicius Daher Alvares
VD
Mocelin
Altair Jacob
AJ
Brunetto
Antônio Fernando
AF
D000328:Adult; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008451:Maximal Voluntary Ventilation / Q000502:physiology; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D006435:Renal Dialysis; D012132:Respiratory Muscles / Q000503:physiopathology*; D013147:Spirometry; D013997:Time Factors; D014797:Vital Capacity / Q000502:physiology; D015430:Weight Gain / Q000502:physiology