High-flux dialysis improves pulmonary ventilation function in uremic patients

摘要

Lung injury commonly accompanies uremia caused by renal failure. Uremia is typically treated using hemodialysis (dialysis) to restore electrolyte and fluid balance. A more recent, less commonly used method, high-flux dialysis, has not yet been investigated for its potential benefit to lung function. The aim of the present study was to determine whether high-flux dialysis affects pulmonary function. We assessed various pulmonary function parameters in patients with uremia before and after routine or high-flux dialysis. Pulmonary function was assessed via determination of the forced vital capacity (FVC), maximum breathing capacity (MBC), forced expiratory volume in 1 sec (FEV1), peak expiratory flow (PEF), maximal midexpiratory flow (MMEF) curve, maximal expiratory flow in 25% vital capacity (V25) and diffusion capacity of the lungs for carbon monoxide (DLco) in 42 patients with uremia and 24 healthy individuals. Patients with uremia were divided into two groups; the high-flux group (treated with high-flux dialysis; n=21) and the routine group (treated with conventional dialysis; n=21). Lung function was reassessed in the two groups after 3 months of dialysis. The two groups of patients with uremia exhibited reduced lung function parameters compared with healthy individuals (all P0.05), indicating the presence of impaired lung function secondary to uremia. Following dialysis, the FEV1, PEF, MMEF and V25 values increased significantly compared with their respective baseline values prior to treatment for each group (ANOVA, P0.05). Furthermore, increases were more marked in patients treated with high-flux dialysis compared with those treated using routine dialysis (P0.05). Thus, lung injury caused by uremia was shown to be improved following dialysis, with high-flux dialysis offering a greater benefit than routine dialysis.