A study of respiratory manifestations in chronic kidney disease

Abstract

Introduction: Diseases of the kidneys can intimately affect lungs by multiple pathological mechanisms, and adversely affect outcome in these patients. Objectives : To study the prevalence of various respiratory diseases in the patients with CKD. Methods: One hundred patients with CKD who were being treated at KIMS, Hubli, from 1 st October 2015 to 30 th June 2016 were considered for the study. Clinical evaluation and relevant investigations including chest radiography, USG chest, CT chest, sputum analysis, pleural fluid analysis and pulmonary function test were done. Echocardiography was done to assess left ventricular function. Polysomnography was done in selected patients. Results: Mean age of study population was 45.50± 13.25 yrs. Sex ratio was 55:45 (M:F). Respiratory diseases were prevalent in 70% of them, commonest being Pulmonary edema(67%), followed by pleural effusion (54%). Pleural effusion was predominantly right sided and transudative. Pulmonary tuberculosis was present in 6% and tuberculous pleural effusion in 2%. Pneumonia occurred in 5% of them. Pleural thickening was present in 11%. Pulmonary calcification was noted by chest X-ray and CT chest in 13%. Sleep apnea was present in 12 out of 20 patients studied. (60%). 2 patients with pneumonia and tuberculosis did not have classical symptoms. Conclusion: The prevalence of respiratory diseases is substantially high in patients with CKD and carries adverse outcome in relation to patient management.