Study of some pulmonary function tests in Egyptian children with end-stage renal disease under regular hemodialysis in correlation with dialysis duration.

Pulmonary function tests can differentiate between obstructive and restrictive lung diseases and assess the severity of the disease in children. The aim of work was to study pulmonary function tests in children with end-stage renal disease (ESRD) undergoing hemodialysis (HD) and its correlation with dialysis duration. This study was conducted on 40 patients with ESRD on regular HD for at least six months selected from the Pediatric Nephrology unit of Pediatric Department of Tanta university hospital and 40 healthy children as a control group. All participants were subjected to full history taking, thorough clinical examination, laboratory investigation: arterial blood gases and pulmonary function tests, including resting spirometry included measurement of lung volumes. There were significantly lower forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC ratio, peak expiratory flow rate, and forced expiratory flow in patients compared with controls and significant positive correlations between dialysis duration and both of FVC and FEV1 in studied patients. There were restrictive spirometric pattern in 30 patients (75%) with ESRD under regular HD and mixed obstructive and restrictive pattern in 10 patients (25%) with highly significant differences between patients and controls regarding patterns of spirometry. There was impairment of lung function in patients with chronic renal failure undergoing HD predominantly of the restrictive pattern. Children with ESRD under regular HD should undergo pulmonary function tests as follow-up investigation to detect associated pulmonary complications included obstructive, restrictive, or mixed patterns of impaired pulmonary function.