title: Impact of hemodialysis on dyspnea and lung function in end stage kidney disease patients.
abstract: BACKGROUND
  Respiratory symptoms are usually underestimated in patients with chronic kidney disease undergoing maintenance hemodialysis. Therefore, we set out to investigate the prevalence of patients chronic dyspnea and the relationship of the symptom to lung function indices.
  
  
  METHODS
  Twenty-five clinically stable hemodialysis patients were included. The mMRC dyspnea scale was applied before and after hemodialysis. Spirometry, single breath nitrogen test, arterial blood gases, static maximum inspiratory (P(imax)) and expiratory (P(emax)) muscle pressures, and mouth occlusion pressure (P 0.1) were also measured.
  
  
  RESULTS
  Despite normal spirometry, all patients (100%) reported mild to moderate degree of chronic dyspnea pre which was reduced after hemodialysis. The sole predictor of (Δ) mMRC was the (Δ) P 0.1 (r = 0.71, P < 0.001). The P(imax) was reduced before and correlated with the duration of hemodialysis (r = 0.614, P < 0.001), whilst after the session it was significantly increased (P < 0.001). Finally (Δ) weight was correlated with the (Δ) P(imax) %pred (r = 0.533, P = 0,006) and with the (Δ) CV (%pred) (r = 0.65, P < 0.001).
  
  
  CONCLUSIONS
  We conclude that dyspnea is the major symptom among the CKD patients that improves after hemodialysis. The neuromechanical dissociation observed probably is one of the major pathophysiologic mechanisms of dyspnea.
authors.affiliation: Respiratory Function Laboratory, 1st Respiratory Medicine Department, Athens University Medical School, "Sotiria" Hospital, 152 Mesogeion Avenue, Athens 11527, Greece.
authors.forename: Anastasios F
authors.initials: AF
authors.lastname: Palamidas
authors.affiliation: Respiratory Function Laboratory, 1st Respiratory Medicine Department, Athens University Medical School, "Sotiria" Hospital, 152 Mesogeion Avenue, Athens 11527, Greece.
authors.forename: Sofia-Antiopi
authors.initials: SA
authors.lastname: Gennimata
authors.affiliation: Respiratory Function Laboratory, 1st Respiratory Medicine Department, Athens University Medical School, "Sotiria" Hospital, 152 Mesogeion Avenue, Athens 11527, Greece.
authors.forename: Foteini
authors.initials: F
authors.lastname: Karakontaki
authors.affiliation: Respiratory Function Laboratory, 1st Respiratory Medicine Department, Athens University Medical School, "Sotiria" Hospital, 152 Mesogeion Avenue, Athens 11527, Greece.
authors.forename: Georgios
authors.identifier: 0000-0002-6852-1553
authors.initials: G
authors.lastname: Kaltsakas
authors.affiliation: Artificial Kidney Unit, Euromedica Athinaion, Kononos Street 121-123, Vyronas, Attica, 16231 Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papantoniou
authors.affiliation: Respiratory Function Laboratory, 1st Respiratory Medicine Department, Athens University Medical School, "Sotiria" Hospital, 152 Mesogeion Avenue, Athens 11527, Greece.
authors.forename: Antonia
authors.identifier: 0000-0002-1536-3205
authors.initials: A
authors.lastname: Koutsoukou
authors.affiliation: Meakins-Christie Labs, McGill University, 3626 Saint Urbain Street, Montreal, QC, Canada.
authors.forename: Joseph
authors.initials: J
authors.lastname: Milic-Emili
authors.affiliation: Renal Unit, Attikon University Hospital, Rimini 1, Haidari, Attika, 12462 Athens, Greece.
authors.forename: Demetrios V
authors.initials: DV
authors.lastname: Vlahakos
authors.affiliation: Respiratory Function Laboratory, 1st Respiratory Medicine Department, Athens University Medical School, "Sotiria" Hospital, 152 Mesogeion Avenue, Athens 11527, Greece.
authors.forename: Nikolaos G
authors.initials: NG
authors.lastname: Koulouris
mesh_terms: D000886:Anthropometry; D001784:Blood Gas Analysis; D001835:Body Weight; D001944:Breath Tests; D004417:Dyspnea / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D006435:Renal Dialysis / Q000009:adverse effects*; D012119:Respiration; D012129:Respiratory Function Tests