ORIGINAL ARTICLE
Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 100-107

Assessment of respiratory muscles' performance in patients with chronic renal failure immediately before and after hemodialysis


1 Department of Pulmonary Medicine, Faculty of Medicine, Ain Shams University, Egypt
2 Department of Nephrology, Faculty of Medicine, Ain Shams University, Egypt

Correspondence Address:
K Wagih
28 Othman Ebnaffan Street Heliopolis, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1687-8426.145699

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Background Physiological abnormalities are frequent in the skeletal muscle structure of patients with chronic renal failure (CRF), and their main signs are fatigue, muscular weakness, and low exercise tolerance. Respiratory muscular weakness may lead to hemodialysis; maximum respiratory pressure measurements may help in early diagnosis and to decide on therapeutic interventions for these patients. Objective To assess the respiratory muscle performance by measuring the maximum inspiratory pressure (PI max ) and the maximum expiratory pressure (PE max ) in patients with CRF immediately before and after hemodialysis (HD). Patients and Methods Sixty patients with CRF were recruited and divided into two groups: group 1 included patients undergoing HD and group 2 included those receiving conservative treatment. All the patients were subjected to arterial blood gases, pulmonary function test, PI max , and PE max . Results There was a significant difference between hemogasometric parameters (pH, PaCO 2 ), PI max %, and spirometric parameters (FEV 1 /FVC%, FEV 1 %, and MMEFR) before and after dialysis. There was, moreover, a significant difference in hemogasometric parameters (PaCO 2 , PaO 2 ), PI max %, and spirometric parameters (FVC%, FEV 1 %, and MMEFR) between CRF patients receiving conservative treatment and those under dialysis before the dialysis session. Furthermore, there was a significant difference in hemogasometric parameters (pH, PCO 2 , PO 2 ), PI max %, and spirometric parameters (FVC, FEV 1 %, FVC, and MMEFR) between both groups. There was a significant inverse relationship between pH and PE max % in group 2 and between PI max % and MMEFR FEV 1 in group 1 before dialysis. In contrast, a significant direct relationship was found between PaO 2 and MMEFR in group 2, between PI max % and FEV 1 in group 1 before dialysis as well as between PE max % and FVC/FEV 1 in group 1 before dialysis. Conclusion There was an obvious decrease in the respiratory muscle performance, arterial blood gases, and spirometric measurements in patients with CRF, both those who were receiving conservative treatment and those under HD, but this decrease was more apparent in those under HD.


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