Comparision between effects of bicarbonate and acetate dialysates on spirometry parameters in patients with chronic renal failure undergoing hemodialysis

Introduction: Chronic renal failure causes impairment of all body organs including
heart and lungs. Main problem in these patients are pulmonary edema due to increased
permeability of capillaries, intravascular and interstitial volume overload, hypertension
and heart failure. These changes cause altered physiologic and mechanical function of
lungs. The objective of this study is evaluating the effect of dialysates and other
intervening factors on spirometry parameters.
Methods: This cross-sectional study was performed on 41 patients with chronic renal
failure in September and October 2006 in Labbafi Nejad Hospital, Tehran. Patients
were randomly divided to bicarbonate and acetate groups. Prior to and after
hemodialysis, patients were meticulously weighed and spirometry parameters (FVC,
FEV1, FEV1/FVC%, FEF 25-75) were measured. Biochemical indices were checked.
Spirometry parameters were analyzed using t-test, and p-value less than 0.05 was
considered statistically significant.
Results: We compared 29 patients undergoing dialysis with bicarbonate and 21
patients on dialysis with acetate. Respiratory function improvement in spirometry
parameters was only significant in patients undergoing dialysis with bicarbonate
dialysate, and when results were compared according to gender, they were
statistically significant only in men. This improvement was meaningful in FEF (25-
75%), FEV1, FVC. Post dialysis weight loss and serum chemistry had no significant
correlation with improvement of sprirometry parameters.
Conclusion: Dialysis with bicarbonate dialysate causes significant improvement in
spirometry parameters and respiratory function in men.