الفهرس | Only 14 pages are availabe for public view |
Abstract Interestingly, in chronic renal failure patients who have many systems affection, the pulmonary system is uniquely affected: • By the chronic renal failure disease process itself. • Renal dialysis therapy. • Complications: as hypoxemia, acid-base imbalance, .... are magnified if there is cardiovascular system compromise which is the main cause of morbidity and mortality in chronic renal failure patients. Uraemic lung and pleural effusion, which is the fluid overload pattern induced by renal failure disease process seems to improve by dialysis, but other many manifestations as: pulmonary calcification, infection and tuberculosis, membrane diffusion defect, impaired ventilatory response to carbon dioxide, restrictive ventilatory response, bronchial hyperreactivity (obstruction), .... etc. behave differently in response to renal dialysis therapy. Peritonial dialysis modality is known to worsen markedly the pulmonary function tests more than haemodialysis. In our present study of pulmonary function tests in chronic renal failure patients: 20 control + 40 patients (20 on thrice/week haemodialysis & 20 on daily dialysis), similar to previous workers, a restrictive ventilatory disturbance as evidenced by decreased forced vital capacity (FVC), decreased forced expiratory volume in first second (FEV1) with peaked expiratory flow rate (PEFR) and forced expiratory flow in twenty five to seventy five percent range (FEF25-75%) and fifty percent range (FEF50%) indicative of the small airways disease affection (obstruction). In addition to fewer results concerning obstructive pattern. Also, there is significant negative correlation between bl.urea, s. creatinine with (FEV1), (FEF25-75%,50%), and (PEFR). Previous studies also proved the above results with the diffusion test using carbon monoxide. Even there was fewer results of bronchial hyper-reactivity documented in our study, but the new issue here is the effect of daily dialysis -a new growing haemodialysis modality in many centers in the world- that already established to improve patients’ quality of life, many systems and also the long term costs of medications and complications’ management. A significant reduction in the restrictive pattern of daily dialysis patients with no obstructive type of pulmonary function tests perse, also, improvement of bl.urea markedly but not serum creatinine. |