PURPOSE: In haemodialysed patients several studies have demonstrated a six-fold increase in plasma concentration of endothelin-1 (ET-1) in comparison with healthy control subjects. It is unknown whether the augmented plasma levels of ET-1 are caused by increased production or decreased degradation or both. However, effects of ET-1 on respiratory function in these patients are much less known. The aim of this study was to determine the potential differences in ventilatory function related to the different levels of ET-1.
METHODS: The study included 28 patients with chronic renal failure receiving regular hemodialysis, without any cardiovascular and respiratory diseases. The participants were divided into two groups according to the levels of ET-1 (in comparison with level of ET-1 in healthy subjects –mean 66 pg/ml). The values of spirometry parameters were recorded after onset of hemodialysis.
RESULTS: Respiratory parameters in patients with levels of serum ET-1 to 66pg/ml: real values: FVC 4.21±1.22; FEV1 3.45±1.04; FEF25-75 4.22±1.76; FEF75 7.15±2.17; FEF50 4.8±2.1; FEF25 2.05±0.87; predicted values: FVC 4.19±0.72; FEV1 3.18 ±0.66; FEF25-75 3.51±1.79; FEF75 7.12±1.25; FEF50 5±0.74; FEF25 2.14 ±0.52. Levels of serum ET-1 greater than 66pg/ml: real values: FVC 3.72±0.84; FEV1 2.59±0.58; FEF25-75 2.24±1; FEF75 5.4±1.8; FEF50 2.6±1.1; FEF25 1.1±0.59; predicted values: FVC 3.73±0.69; FEV1 2.87±0.62; FEF25-75 3.04±0.75**; FEF75 6.8±1.1**; FEF50 4.7±0.67**; FEF25 1.9±0.52**.
CONCLUSION: Grater level of ET-1 in hemodialysis patients than in healthy subject (mean 66pg/ml) have adverse effect to parameters of lung volume tests. A possible pathophysiological mechanism for deterioration of pulmonary function might lead to progression of inflammations, pulmonary oedema well known as “uraemic lung” or/and the progression of pulmonary hypertension.
CLINICAL IMPLICATIONS: Development of restrictive ventilatory disturbance present a therapeutic dilemma. The efficacy of current medical therapeutics such as ET-1 blockers, antioxidant (acetylcisteine high dose) has not been studied in this syndrome.
DISCLOSURE: Mirko Stanetic, No Financial Disclosure Information; No Product/Research Disclosure Information