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强化家庭血液透析致肺限制性参数改变:病例报告。

Changes in pulmonary restrictive parameters by intensive home hemodialysis: a case report.

机构信息

Division of Nephrology, University of Toronto, 200 Elizabeth Street, 8N room 846, Toronto, ON, M5G 2C4, Canada.

University Health Network, Toronto, Canada.

出版信息

BMC Nephrol. 2020 Aug 3;21(1):322. doi: 10.1186/s12882-020-01977-5.

DOI:10.1186/s12882-020-01977-5
PMID:32746797
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7397629/
Abstract

BACKGROUND

Patients with End-Stage Renal Disease (ESRD) are at an increased risk for restrictive lung disease due to accumulation of uremic toxins and volume overload. Hemodialysis is the preferred treatment for improving lung function in dialysis patients. However, the effects of fluid removal and solute clearance by hemodialysis on lung function remain unclear.

CASE PRESENTATION

We report a case of restrictive lung disorder in a hemodialysis patient, who showed improvement in both clinical and spirometric lung function after initiation of intensive home hemodialysis (32 h per week).

CONCLUSION

Intensive hemodialysis augments fluid removal and solute clearance, which in turn may improve restrictive lung function.

摘要

背景

终末期肾病(ESRD)患者由于尿毒症毒素蓄积和容量超负荷而患限制性肺病的风险增加。血液透析是改善透析患者肺功能的首选治疗方法。然而,血液透析清除液体和溶质对肺功能的影响尚不清楚。

病例介绍

我们报告了一例血液透析患者的限制性肺疾病,该患者在开始强化家庭血液透析(每周 32 小时)后,临床和肺功能的限制性均得到改善。

结论

强化血液透析可增加液体清除和溶质清除,从而可能改善限制性肺功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b6/7397629/1ada15d01032/12882_2020_1977_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b6/7397629/1ada15d01032/12882_2020_1977_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03b6/7397629/1ada15d01032/12882_2020_1977_Fig1_HTML.jpg

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本文引用的文献

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Restrictive lung disorder is common in patients with kidney failure and associates with protein-energy wasting, inflammation and cardiovascular disease.限制性肺疾病在肾衰竭患者中很常见,与蛋白质能量消耗、炎症和心血管疾病有关。
PLoS One. 2018 Apr 27;13(4):e0195585. doi: 10.1371/journal.pone.0195585. eCollection 2018.
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Lung Dysfunction and Mortality in Patients with Chronic Kidney Disease.慢性肾脏病患者的肺功能障碍与死亡率
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The effect of diuresis on extravascular lung water and pulmonary function in acute decompensated heart failure.
利尿剂对急性失代偿性心力衰竭患者肺血管外水和肺功能的影响。
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Pulmonary Function in Patients with End-Stage Renal Disease: Effects of Hemodialysis and Fluid Overload.终末期肾病患者的肺功能:血液透析和液体过载的影响
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