The effect of a single hemodialysis session on pulmonary functions in patients with end-stage renal disease

Abstract

Objective: Changes in pulmonary functions have not been thoroughly investigated in patients undergoing hemodialysis (HD). The aim of this study was to determine the effect of a single HD session on pulmonary functions, measured by spirometry, in patients with end-stage renal disease (ESRD) undergoing chronic hemodialysis (CHD) treatment.

Methods: Thirty patients with ESRD who were on CHD treatment for at least 12 months between January 2018 and January 2020 were enrolled. The pre-dialysis and post-dialysis spirometric measurements were recorded by a portable spirometry device.

Results: The mean age and HD vintage of 30 patients (70% male, 20% diabetic, mean BMI: 26.0 +/- 4.7 (kg/m(2))) were 55.6 +/- 11.4 years and 117.6 +/- 66.3 months, respectively. Half of the patients (50%) were smokers (mean 11.5 +/- 13.59 packs/year). The spirometric measurements of most of the patients were abnormal (40% restrictive, 30% obstructive respiratory disorder, 30% normal). The FEV3(L), predicted FEV1(%), FEF25(L), and predicted FEF25(%) values were significantly increased after the HD session. A positive correlation between BMI and Delta FEV3 (L) values (r = 0.377, P =.04) was observed. A significant improvement in FEV3 values after a single HD session was recorded, which was independently related to higher BMI (beta = 0.501, P <.01) and non-smoking (beta = 0.495, P <.05).

Conclusion: Spirometric measurements are abnormal in most CHD patients, and a considerable improvement in pulmonary functions is possible with a single HD session. Having a high BMI and being a non-smoker appear to have significant positive effects on amelioration in FEV3 (L). Larger trials are needed to evaluate pulmonary functions in CHD patients.