Naslov
Renal failure and the lung

Autori
Vrbica, Žarko ; Car, Antun ; Ilić, Mario ; Mlinarić- Vrbica, Sanja

Vrsta, podvrsta i kategorija rada
Poglavlja u knjigama, znanstveni

Knjiga
LUNG IN NON-PULMONARY AND SYSTEMIC DISEASE

Urednik/ci
Peroš-Golubičić, Tatjana

Izdavač
Medicinska naklada

Grad
Zagreb

Godina
2013

Raspon stranica
45-52

ISBN
978-953176-577-0

Ključne riječi
renal failure, lung, Doppler echocardiography

Sažetak
Chronic renal failure can exert multiple disturbances in lung function. Knowledge of common conditions that affect lungs can spare unnecessary aggressive diagnostic procedures and assure prompt and proper treatment. There are also specific issues regarding the treatment of different lung conditions in patients with chronic renal failure or undergoing haemodialysis (HD) treatment. Lung are affected by renal failure and HD procedure. Toxic effects of uraemia, pulmonary hypertension and oedema combined with pneumonitis make the most common respiratory condition in uremic patients called „the uremic lung“.Exudate caused by pleural inflammation in uraemia are usually hemorrhagic and associated with the pleuritic pain and often resolve without specific treatment. Pulmonary calcifications are usual in long term HD and my cause clinically significance disease. Pneumonias are more frequent in dialysis population. There is proven benefit of vaccinations against influenza, hepatitis B, pneumococcus, and varicella.The risk of tuberculosis (TB) is increased in patients on HD with higher rate of extra pulmonary TB. All patients on HD should have initial chest x-ray. Tuberculin skin test (TST) has reduced responsiveness and interferon gamma release assay (IGRA) test is more useful. It is better to increase the dosage interval then to reduce the dose. Lung function can deteriorate during the HD session, with hypoventilation caused by loss of CO₂ and acidotic stimulation. Asthma attacks occur more often with acetate dialysis. Peritoneal dialysis (PD) can cause hypercapnia, decrease in vital capacity and acute respiratory acidosis that restore to baseline in 2-3 weeks. Pulmonary hypertension is caused by microembolisation of lung vessels, leukocyte activation and trapping due to complement activation in contact with dialysis membrane. Early diagnosis by Doppler echocardiography can lead to early intervention and prevent deterioration of right ventricle function.

Izvorni jezik
Engleski

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