Uremic lung is different entity then oedema present in cardiovascular diseases or in adult respiratory distress syndrome as well. This state is one of the possible complications in patients with chronic renal failure (CRF) receiving regular hemodialysis (HD). It appears upon hydrostatic and colloidal pressure disbalance in lung capillaries and interstitial space leading to accumulation of oedematous liquor in interstitum and alveols. There are several studies suggesting that in these patients in 30-40% cases pulmonary hypertension was developed. The data also showed that primary as well secondary pulmonary hypertension are more often developed in females; even real reason is still unknown. The aim of the study was to estimate the ventilator function improvement in patients with CRF receiving regular HD related to sex differences.
The study population consisted in 39 patients (males, females koliko?) with CRF, with no cardiac and pulmonary diseases. These patients were treated by regular hemodialysis using bicarbonate or acetate mode, respectively (Table 1). They were divided into two groups according to the sex. Spirometry parameters as vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), before and after onset of hemodialysis were recorded. The results were analyzed using Student t-test and presented as mean ±SD. All p values <0,05 were considered significant.
Table 1.SexMalesFemalesBicarbonatei modul79 %65 %Acetatei modul21 %35 %
The result showed that ventilatory function in male patients is significantly improved, especially VC and FEV1, whereas in female patients improvement had not statistical significance (Table 2).
Table 2.SpirometryMalesFemalesFunction pareametersBefore HDAfter HDBefore HDAfter HDVC3.6 L4.0 L*2.5 L2.5 LFVC3.8 L/s3.8 L/s2.53 L/s2.57 L/sFEV13.2 L/s3.4 L/s*2.29 L/s2.26 L/s*
p < 0.05
It can be concluded that one of the possible reasons for slight improvement of ventilator function in female patients is greater random usage of acetate mode for HD.
Recommendation refers to preferable use of bicarbonate mode in HD treatment in patients diagnosed uremic lung.
P.M. Kovacevic, None.