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慢性肾脏病不同阶段的肺部表现:一项观察性研究

Pulmonary Manifestations at Different Stages in the Chronic Kidney Disease: An Observational Study.

作者信息

Parivakkam Mani Anbumaran, K Shanmugapriya, Sundar Raja, Yadav Sankalp

机构信息

Respiratory Medicine, Saveetha Medical College and Hospital, Chennai, IND.

Respiratory Medicine, Sri Lalithambigai Medical College and Hospital, Dr. MGR Educational and Research Institute, Tamil Nadu, IND.

出版信息

Cureus. 2023 May 19;15(5):e39235. doi: 10.7759/cureus.39235. eCollection 2023 May.

Abstract

INTRODUCTION

By a variety of pathogenic pathways, kidney diseases can have a direct negative impact on the lungs and worsen the prognosis for those with chronic renal disease. Chronic kidney disease (CKD) is a public health concern throughout the world. The relationship between the kidneys and lungs is crucial for maintaining acid-base balance, fluid homeostasis, and blood pressure control. These patients have a higher prevalence of lung dysfunction regardless of the disease's stage, including sleep apnea syndrome, pulmonary hypertension, and chronic obstructive pulmonary disease (COPD). The chance of getting a pulmonary consequence increases with the severity of kidney disease. In individuals with chronic renal disease, this study looked at the prevalence of several respiratory disorders.

MATERIALS AND METHODS

From February 2021 to October 2021, 70 CKD patients who were receiving care at the Saveetha Medical College and Hospital were taken into consideration for the study. Clinical assessment and pertinent tests, such as a pulmonary function test, chest radiography, CT chest, sputum analysis, and pleural fluid analysis were performed. To evaluate left ventricular function, echocardiography was performed. Selected patients underwent polysomnography.

RESULTS

The study's population had a mean age of 50 years. There was a 20:50 sex ratio (M:F). Seventy percent of them had respiratory conditions, the most frequent of which was pleural effusion (70%), followed by pulmonary edema (52%). The pleural effusion was primarily transudative and right sided. Both tuberculous pleural effusion and pulmonary tuberculosis were detected in 2% of the population. Seven percent of them developed pneumonia. 10% of patients had thickening of the pleura. Using chest CT and x-ray, 3% of patients had pulmonary calcification visible. In 12 (60%) out of the 20 patients who were studied, sleep apnea was observed. Two patients with tuberculosis and pneumonia lacked the typical signs.

CONCLUSIONS

In our research study, CKD patients have a much higher preponderance of respiratory illnesses, which has negative effects on patient care.

摘要

引言

通过多种致病途径,肾脏疾病可对肺部产生直接负面影响,并使慢性肾病患者的预后恶化。慢性肾病(CKD)是全球关注的公共卫生问题。肾脏与肺之间的关系对于维持酸碱平衡、液体稳态和血压控制至关重要。无论疾病处于何阶段,这些患者出现肺功能障碍的患病率更高,包括睡眠呼吸暂停综合征、肺动脉高压和慢性阻塞性肺疾病(COPD)。肺部并发症的发生几率随肾脏疾病的严重程度增加而升高。在慢性肾病患者中,本研究观察了几种呼吸系统疾病的患病率。

材料与方法

2021年2月至2021年10月,本研究纳入了在萨维塔医学院和医院接受治疗的70例CKD患者。进行了临床评估和相关检查,如肺功能测试、胸部X线摄影、胸部CT、痰液分析和胸腔积液分析。为评估左心室功能,进行了超声心动图检查。选定的患者接受了多导睡眠图检查。

结果

研究人群的平均年龄为50岁。男女比例为20:50。其中70%患有呼吸系统疾病,最常见的是胸腔积液(70%),其次是肺水肿(52%)。胸腔积液主要为漏出液,且右侧居多。2%的人群同时检测出结核性胸腔积液和肺结核。7%的人发生了肺炎。10%的患者胸膜增厚。通过胸部CT和X线检查,3%的患者可见肺部钙化。在20例接受研究的患者中,有12例(60%)观察到睡眠呼吸暂停。两名患有肺结核和肺炎的患者缺乏典型体征。

结论

在我们的研究中,CKD患者呼吸系统疾病的患病率要高得多,这对患者护理产生了负面影响。

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