Youssef Doaa Mohammed, Shokry Dina M, Elbehidy Rabab Mohammed, Mohammed Khedr Mahmoud Khedr
Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Saudi J Kidney Dis Transpl. 2018 May-Jun;29(3):578-585. doi: 10.4103/1319-2442.235174.
The relationships between the lungs and the kidneys are clinically important; however, the impact of nitric oxide (NO) on respiratory function in renal patients is less known. The aim of this study is to evaluate pulmonary function tests (PFTs), NO level and their correlation in children on treatment with hemodialysis (HD) for the end-stage renal disease. This study was performed among 20 patients on regular HD and 20 controls. Participants were subjected to clinical examination, and pulmonary function evaluation was performed using spirometry. The following parameters were obtained as follows: forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), Tüffenau index (FEV1/%FVC), (FEF25%-75%), and peak expiratory flow. Spirometry was carried out before and after HD sessions, and at the same time of clinical assessments, blood samples were taken to measure arterial-blood gas (ABG) and NO levels. There was the statistically significant difference between patient and control groups regarding NO and all PFTs except FEV1/FVC. There was no statistically significant correlation between NO and biological parameters in both cases and controls, but there was negative although the statistically not significant correlation between the PFTs, ABG, and duration of dialysis in the case group. There was statistically significant negative correlation between NO and some PFTs in case group; also the effect of dialysis on pulmonary functions tests and NO levels were only on the FVC of patients which significantly improved. Postdialysis blood gases remained normal among children on HD. NO may be involved in the deterioration of pulmonary function, and therefore, we feel that it can be used as a marker of clinical deterioration.
肺与肾之间的关系在临床上很重要；然而，一氧化氮（NO）对肾病患者呼吸功能的影响尚鲜为人知。本研究旨在评估终末期肾病接受血液透析（HD）治疗的儿童的肺功能测试（PFTs）、NO水平及其相关性。本研究在20例定期接受HD治疗的患者和20例对照中进行。参与者接受临床检查，并使用肺活量测定法进行肺功能评估。获得了以下参数：用力肺活量（FVC）、第1秒用力呼气量（FEV1）、图夫瑙指数（FEV1/%FVC）、（FEF25%-75%）和呼气峰值流速。在HD治疗前后进行肺活量测定，同时在临床评估时采集血样以测量动脉血气（ABG）和NO水平。除FEV1/FVC外，患者组与对照组在NO和所有PFTs方面存在统计学显著差异。在病例组和对照组中，NO与生物学参数之间均无统计学显著相关性，但病例组中PFTs、ABG与透析时间之间存在负相关尽管无统计学显著性。病例组中NO与一些PFTs之间存在统计学显著负相关；透析对肺功能测试和NO水平的影响仅体现在患者的FVC上，其显著改善。接受HD治疗的儿童透析后血气仍保持正常。NO可能参与了肺功能的恶化，因此，我们认为它可作为临床恶化的一个指标。
