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Abstract: FR-PO0433

Maintenance Hemodialysis and Its Effect on Pulmonary Function in Patients with CKD

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Bohlke, Maristela, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
  • Lucio Garcia Pires, Ana Carolina, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
  • Fabiane, Pedro Henrique, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
  • Barcellos, Pedro, Universidade Catolica de Pelotas, Pelotas, RS, Brazil
  • Kohn, Eduardo Ribes, Univerzita Palackeho v Olomouci, Olomouc, Czechia
Background

Alterations in pulmonary function can significantly impair daily life activities. Fluid overload is a factor that can compromise respiratory mechanics among individuals treated by maintenance hemodialysis (HD). HD removes metabolic waste and excess fluids, which may improve pulmonary function. This study aims to evaluate the impact of an HD session on lung volume and pressures and the potential association of these variables with HD ultrafiltration (UF).

Methods

This before-and-after study included individuals on maintenance HD at a southern Brazilian university hospital. Spirometric and manovacuometry parameters were evaluated before and after a mid-week HD session. Chi-square, t-test, and Wilcoxon tests were used in statistical analysis. A numerical delta (after HD – before HD values) was calculated for numerical variables and used for adjusted analysis through linear regression. Multilevel adjusted analysis using linear regression was employed to determine the association between changes in lung capacities and pressures and ultrafiltration (UF) volume.

Results

The study included 104 participants, with a median age of 54.1 (IQR 42.7–69.2) years, 57.7% male. The mean UF during the HD session was 2.68 (1.06) liters. There was an increase in peak expiratory flow (PEF) from 46.1 ± 25.1 to 48.5 ± 22.7 L/min (p=0.02), the FEV1/FVC ratio improved from 113.8 ± 21.2 to 118.4 ± 20.1 (p=0.01), and both maximal inspiratory pressures (MIP) rose from 64.5 ± 29.0 to 69.9 ± 32.1 (p<0.001) and expiratory pressures (MEP) increased from 71.3 ± 39.6 to 79.7 ± 35.4 (p<0.001) after the HD session. The percentage of participants classified as having restrictive (56% to 43%, p<0.001) and obstructive (4.2% to 3.2%, p<0.001) pulmonary diseases also decreased after HD. Additionally, there was a significant association between delta FEV1/FVC (p=0.03), delta MEP (p=0.05), and delta PEF (p=0.03) with ultrafiltration volume.

Conclusion

The spirometric variables FEV1/FVC ratio and FEF, as well as the pressure variables MEP and MIP, increased from before to after HD, suggesting some effect of the procedure on lung health in maintenance HD recipients. The association between the changes in FEV1/FVC, MEP, and PEF with the volume of UF removed suggests that this salutary effect of HD is, at least partially, due to fluid removal.

Digital Object Identifier (DOI)