Assessment of functional capacity and pulmonary in pediatrics patients renal transplantation

Renata Salatti Ferrari,Janice Luisa Lukrafka,Mariane Borba Monteiro,Clotilde Druck Garcia,Juliana Mendes,Camila Wohlgemuth Schaan,Karina Cerutti

doi:10.5935/01012800.20130006

Abstract

Pediatric patients undergoing kidney transplantation can present changes in pulmonary function and functional capacity for exercise. To evaluate the functional capacity and pulmonary function in children and adolescents undergoing kidney transplantation. Children and adolescents aged six to 18 years of age were evaluated in Outpatient Clinic of Nephrology, Hospital da Criança Santo Antônio, Santa Casa de Porto Alegre, RS, Brazil in period the june of 2010 the march of 2011. Pulmonary capacity was assessed by spirometry and maximal respiratory pressures and functional capacity through 6-minute walk test (6MWT). The sample comprised 25 patients, 14 (56%) males with a mean age of 13.5 ± 3.3 years. From, 19 (76%) underwent dialysis before transplantation. Mean forced vital capacity (FVC) was 97.91 + 24.32% and forced expiratory volume in one second (FEV1) 100.53 + 17.66% from predicted value. In the 6MWT, the patients walked 229.14 meters less than predicted (p < 0.001). The maximum inspiratory pressure (MIP) was significantly lower than predicted, and the difference in cmH₂O -24.63 (p = 0.03), as the maximum expiratory pressure (MEP), with a difference of 49.27 cmH₂O (p < 0.001). By correlating, functional capacity, spirometry and maximal respiratory pressures, find an association between FVC and 6MWT (r = 0.52, p = 0.01) and FVC and MIP (r = 0.54, p = 0.01). Reduced functional capacity and maximum respiratory pressures were diagnosed in a small cohort of pediatric patients after kidney transplantation. Better the functional capacity and PiMáx better the FVC.

Highlights

Pediatric patients undergoing kidney transplantation can present changes in pulmonary function and functional capacity for exercise
Children and adolescents aged six to 18 years of age were evaluated in Outpatient Clinic of Nephrology, Hospital da Criança Santo Antônio, Santa Casa de Porto Alegre, RS, Brazil in period the june of 2010 the march of 2011
Pulmonary capacity was assessed by spirometry and maximal respiratory pressures and functional capacity through 6-minute walk test (6MWT)

Summary

Introduction

Pediatric patients undergoing kidney transplantation can present changes in pulmonary function and functional capacity for exercise. Renal transplantation is considered to be the most effective therapy for the treatment of chronic renal insufficiency (CRI), and can potentially improve or normalize renal function It is the treatment of choice for most etiologies, in patients with terminal or preterminal uremia.[3,4]. Because renal transplant is indicated in cases of CRI, the complications with which these patients present prior to replacement therapy, such as fluid overload, respiratory infections, acidosis, pulmonary fibrosis and calcifications, and alterations in the ventilation/perfusion rate, should be considered. Such changes may lead to the development of other pulmonary disorders, such as edema or pleural effusion. Among the more common pulmonary alterations are limitations to airflow in the distal airways, obstructive disorders, and reduced pulmonary diffusion capacity.[5,6,7,8]

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Conclusion