Comparision between effects of bicarbonate and acetate dialysates on spirometry parameters in patients with chronic renal failure undergoing hemodialysis

ABSTRACT

Chronic renal failure causes impairment of all body organs including heart and lungs. Main problem in these patients are pulmonary edema due to increased permeability of capillaries, intravascular and interstitial volume overload, hypertension and heart failure. These changes cause altered physiologic and mechanical function of lungs. The objective of this study is evaluating the effect of dialysates and other intervening factors on spirometry parameters. This cross-sectional study was performed on 41 patients with chronic renal failure in September and October 2006 in Labbafi Nejad Hospital, Tehran. Patients were randomly divided to bicarbonate and acetate groups. Prior to and after hemodialysis, patients were meticulously weighed and spirometry parameters [FVC, FEV1, FEV1/FVC%. FEF 25-27] were measured. Biochemical indices were checked. Spirometry parameters were analyzed using t-test, and p-value less than 0.05 was considered statistically significant. We compared 29 patients undergoing dialysis with bicarbonate and 21 patients on dialysis with acetate. Respiratory function improvement in spirometry parameters was only significant in patients undergoing dialysis with bicarbonate dialysate, and when results were compared according to gender, they were statistically significant only in men. This improvement was meaningful in FEF [25-27%], FEV1, FVC. Post dialysis weight loss and serum chemistry had no significant correlation with improvement of spirometry parameters. Dialysis with bicarbonate dialysate causes significant improvement in spirometry parameters and respiratory function in men