Abstract
This study was carried out to investigate the impact of duration of different renal replacement therapies such as hemodialysis and continuous ambulatory peritoneal dialysis on potential overproduction of endothelin-1 (ET-1) and pulmonary function tests in these patients. The study included 26 patients (14 males, mean age 54.9±16.2 years) with end stage renal diseases (ESRD) receiving regular hemodialysis (HD) and 23 patients (10 males, mean age 55.8±15.8 years) with ESRD treated with continuous ambulatory peritoneal dialysis (CAPD). The spirometry values were recorded before the onset of HD and prior to emptying the peritoneal cavity in CAPD patients and ET-1 was measured using the enzyme immunoassay (EIA) methodology. Two groups of patients (groups 1 and 2) were further divided into subgroups (group A and group B). Groups A (1-A and 2-A) included patients treated with any type of renal replacement therapy (RRT) (HD or CAPD) less than 5 years, and groups B (1-B and 2-B) included patients treated with any type of RRT (HD or CAPD) longer than 5 years. Patients treated with HD or CAPD for more than five years were found to have significantly higher serum levels of ET-1 (HD = 41.49±21.28 vs. 185.13±73.67, p<0.01; PD = 51.24±32.11 vs. 139.53±42.42, p<0.01, respectively). Values of most pulmonary function parameters differed significantly between groups treated longer or shorter than 5 years: FVC (HD = 108.4±13.34 vs. 80.82±11.26, p<0.01; CAPD = 97.20±18.99 vs. 73.25±10.73, p<0.01, respectively), FEV1 (HD = 108.33±15.8 vs. 76.73±4.9, p<0.01; CAPD = 100.67±18.31 vs. 66.75±6.25, p<0.01, respectively). Prolonged duration of any type of renal replacement therapy is associated with higher serum levels of ET-1 and with lower pulmonary function tests in ESRD patients.
Highlights
This study was carried out to investigate the impact of duration of different renal replacement therapies such as hemodialysis and continuous ambulatory peritoneal dialysis on potential overproduction of endothelin-1 (ET-1) and pulmonary function tests in these patients
The aim of this study was to investigate the impact of duration of different renal replacement therapy (RRT) (HD and continuous ambulatory peritoneal dialysis (CAPD)) on potential overproduction of ET-1 and pulmonary function tests values in end stage renal diseases (ESRD) patients
The main finding of this study is that ET-1 levels are significantly higher in patients subjected to RRT (HD or CAPD)
Summary
This study was carried out to investigate the impact of duration of different renal replacement therapies such as hemodialysis and continuous ambulatory peritoneal dialysis on potential overproduction of endothelin-1 (ET-1) and pulmonary function tests in these patients. Spirometry changes in observed population treated with chronic RRT have reversible character during the first years of the treatment.[11,12] Fluid overload, together with a potential increase in pulmonary capillary permeability, can result in pulmonary edema and pleural effusion, abnormalities that could explain, at least in part, the decrease in pulmonary function.[13,14] Along with the progression of the disease, microinflammatory changes, which include activation of whole spectrum of mediators, develop.[15] complications of the same process lead to irreversible changes, which might explain the irreversibility of the pulmonary function tests changes after the RRT.[4,12] Apart from these findings, a number of studies provide data which shows the existence of a vasoactive molecule imbalance in uremic patients, primarily endothelin-1 (ET-1).[16,17] In addition to its powerful vasoactive effects, ET-1 causes bronchoconstriction as well.[18,19] There is a small number of studies which investigated the connection of long-term RRT (HD and CAPD) and ET-1 overproduction and its effects on pulmonary function tests in these patients
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