Assessment of Respiratory Muscles Performance in Patients with Chronic Renal Failure Immediately before and after Hemodialysis

Abstract

Chronic renal failure (CRF) is characterized by progressive and irreversible destruction of renal structures. The respiratory system suffers alterations in respiratory drive, pulmonary mechanics, muscle function and gas exchange. This pulmonary dysfunction may be a direct result of the circulation of toxins or, indirectly, from the excess volume due to the increased quantities of circulating body fluids, anemia, immunological suppression, drugs and deficient nutrition (David J. and Pierson, 2006).

Physiological abnormalities are frequent in the skeletal muscle structure of patients with CRF , and their main signs are fatigue, muscular weakness and low exercise tolerance Respiratory muscular weakness may lead to hypoventilation, maximum respiratory pressure measurements may help in early diagnosis and therapeutic interventions for these patients(Sala et al., 2001).

The aim of this study is to assess the respiratory muscle performance by measuring the maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) in chronic renal failure patients under conservative treatment and immediately before and after hemodialysis. This study was carried out between Pulmonary Function Unit Chest Department and Renal Dialysis Unit in Ain Shams University Hospital in the period from January 2012 to January 2013. Sixty patients with chronic renal failure were included in this study and they were divided in to 2 groups: • Group 1: Thirty patients with chronic renal failure undergoing regular hemodialysis for at least 6 months to study the effect of CRF and hemodialysis on respiratory muscle function.

• Group 2: Thirty patients with chronic renal failure under conservative treatment to study the effect of CRF on respiratory muscle function were as a control group. All patients were subjected to the following: • Full history taking.