title: Effect of Dialysis on Maximum Inspiratory and Expiratory Pressures in End Stage Renal Disease Patients.
abstract: BACKGROUND
  Muscle weakness especially weakness of the respiratory muscles is a complication of chronic kidney disease. The cause of muscle weakness is the accumulation of excessive amounts of urea and other toxins. The aim of this study was to assess the effect of hemodialysis on respiratory muscle strength by measuring maximum inspiratory (PI max) and expiratory pressure (PE max).
  
  
  METHODS
  A cross sectional study was carried out on 31 patients with chronic kidney disease at Modarres hospital in 2012. Before hemodialysis, patients had their PI max and PE max taken by using a manovacuometer. After that, the patients were connected to the dialysis machine. At the end of the hemodialysis, the patients had their PI max measured again. Data were assessed by the multivariate regression test.
  
  
  RESULTS
  Before dialysis, PI max and PE max were lower than normal levels. After the hemodialysis session, repeat PFT revealed an increase in PE max and no significant change in PI max. There were strong correlations between hypoalbuminemia, anemia, hypercalcemia, hyperphosphatemia, hyperparathyroidism and decreased respiratory muscle strength. Also, the respiratory muscle strength decreased in the elderly and women.
  
  
  CONCLUSIONS
  Respiratory muscle weakness is a complication of chronic kidney disease; hemodialysis can improve muscle strength and PI max.
authors.affiliation: Department of Pulmonary Medicine, Shaid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Sasan
authors.initials: S
authors.lastname: Tavana
authors.affiliation: Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Mohammadreza
authors.initials: SM
authors.lastname: Hashemian
authors.affiliation: Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Fatemeh Kazemi
authors.initials: FK
authors.lastname: Jahromi
keywords: Chronic kidney disease; Dialysis; Respiratory muscle strength