Effect of uremia and its treatment on pulmonary function

Research output: Contribution to journalReview article

62 Scopus citations

Abstract

Alterations in respiratory drive, mechanics, muscle function, and gas exchange are frequent if not invariable consequences of uremia. Pulmonary dysfunction may be the direct result of circulating uremic toxins or may result indirectly from volume overload, anemia, immune suppression, extraosseous calcification, malnutrition, electrolyte disorders, and/or acid-base imbalances. The pulmonary system is unique because it is affected by the disease and its treatment. Acetate hemodialysis reduces alveolar ventilation and PaO 2 due to extrapulmonic CO 2 unloading. Peritoneal dialysis increases alveolar ventilation and intraperitoneal pressure. The latter leads to an elevated and lengthened diaphragm, a reduced functional residual capacity, basilar atelectasis, possible hypoxemia, and altered respiratory muscle function. In patients on chronic peritoneal dialysis, adaptations may occur that limit the reductions in lung volumes, PaO 2, and respiratory muscle strength that are often observed during acute peritoneal dialysis. This review details how uremia and dialysis interact to alter pulmonary function.

Original languageEnglish (US)
Pages (from-to)1-14
Number of pages14
JournalLung
Volume168
Issue number1
DOIs
StatePublished - Dec 1 1990

Keywords

  • Hemodialysis
  • Peritoneal dialysis
  • Pulmonary function
  • Uremia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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