#5129 CLINICAL-FUNCTIONAL KIDNEY-LUNG LINK IN A POPULATION OF HEMODIALYZED PATIENTS

Abstract

Abstract Background and Aims We know that lung and kidney are intimately related from a functional standpoint, both in physiological conditions and in diseases. The close relationship between lung and kidney (kidney-lung link) is evidence of a homeostatic connection between all organs and systems in an attempt to maintain the body system balance. In a recent review [1] we emphasized the importance to search for the clinical signs of a disease not only in the primary affected organ but also in organ functionally related. Method For this purpose we examined 81 hemodialyzed patients, with a mean age of 66.6 ± 13 years (28 f and 53 M), undergoing hemodialysis treatment (mean dialysis: 96 ± 34 months), with regard to smoking habits (47 non-smokers and 34 smokers with an average of 19.8 cigarettes per day: pack / years: 33.4 ± 2.9). Pulmonary function test (PFT) and clinical signs were evaluated. we excluded 6 patients (4 males and 2 females) in the smoking group with obstructive spirometric pattern (detected by a FEV1.0/FVC ratio lower than 70 absolute value), so that the final non-smoking group consisted of 47 patients and the smoking-group by 28 smokers: both groups matched for anthropomorphic data. Results The mean values of PFT were globally no different between smokers with normal PFT and non smokers are summarized in Table 1: Although the never-smoking group was nearly twice as large as the smokers, and PFT were similar and normal, respiratory symptoms were predominant: daily cough (49 yes; 26 no); chronic phlegm (51 yes; 24 no). Conclusion in dialysis patients, cough and phlegm are common symptoms, regardless of smoking and spirometric values. Probably these results are the consequence of synergistic effects between lungs and kidneys, as recently demonstrated [2]. Hence the need to evaluate dialysis patients from the clinical-functional point of view of both, kidneys and lungs, in order to evaluate the appropriate, personalized, therapeutic strategy according to the last evidences of the literature [3].