Hemodialysis without Ultra Filtration is more effective than with Ul-tra Filtration on Spirometry Parameters

Aim: Respiratory dysfunction is one of the most common problems among patients with end stage renal disease (ESRD). The aim of the present study is to evaluate the effects of hemodialysis (HD) with and without ultra filtration on various parameters of pulmonary function test among these patients. Methods and Materials: one hundred sixty ESRD patients undergoing maintenance HD more than 3 months and without acute lung disease were included in the study. HD was done using Fresenius 4008B dialysis machines, synthetic dialyzer membranes, bicarbon-ate base dialysate and with zero to 1-4 lit ultra filtration rate during each session. Spi-rometry test was performed before and immediately after a 4-hour HD session and al-terations in spirometry parameters including forced expiratory volume in first second (FEV1), forced vital capacity (FVC) and maximal mid expiratory flow rate (MMEF) were determined and their relations with ultra filtration rate were analyzed. Results: The most common causes of ESRD were hypertension in 65 (40.6 %) and dia-betes mellitus in 46 (27.7%). Three patterns in spirometry were found among our pa-tients; obstructive, restrictive and normal pattern in 20%, 35.6% and 44.4% respectively.There was a significant increase in FEV1, FVC and FEF 25-75% after dialysis (P < 0.001). But, the average rate of increment in FEV1 and FVC was higher in patients undergoing hemodialysis without ultra filtration versus ultra filtration and the difference was statistically significant (FEV1, P = 0.04 and FVC, P = 0.001). Conclusion: According to the results of our study, spirometry parameters increase significantly after a session of HD but these increments were much more in patients undergoing HD without ultra filtration.