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Associations of pulmonary function with serum biomarkers and dialysis adequacy in patients undergoing peritoneal dialysis

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Abstract

Background

As lung impairment is an indicator of increased morbidity and mortality in patients receiving continuous ambulatory peritoneal dialysis (CAPD), the risk factors associated with impaired lung function are of great significance. The aim of this study is to elucidate the effects of inflammatory biomarkers and dialysis adequacy on pulmonary function, in CAPD patients.

Methods

101 patients undergoing CAPD, 30 CKD5 patients and 30 healthy subjects were enrolled. Spirometry and serum biomarkers were evaluated in each subject. Pulmonary function was compared among patients and control groups. Pearson analysis was used to analyze the correlation between serum biomarkers, dialysis adequacy and pulmonary function.

Results

Lower vital capacity, maximal voluntary ventilation (MVV), forced vital capacity (FVC), peak expiratory flow (PEF), maximal mid-expiratory flow rate (MMEF), and diffusing capacity of the lung for carbon monoxide (DLCO) were observed in the CAPD group (all P < 0.05) when compared with control subjects. DLCO % was negatively correlated with CRP (r = −0.349, P = 0.007) and positively correlated with albumin (r = 0.401, P = 0.002). Total Kt/V was associated positively with MMEF % (r = 0.316, P = 0.019), and MVV % (r = 0.362, P = 0.007). nPNA was positively correlated with FVC % (r = 0.295, P = 0.049) and MMEF % (r = 0.381, P = 0.010).

Conclusion

The results suggest that lung function decline was directly related to higher CRP level, hypoalbuminemia, and dialysis inadequacy. These findings provide the evidence that inflammation and dialysis adequacy play a role in predicting outcomes of CAPD patients with pulmonary impairment.

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Abbreviations

CAPD:

Continuous ambulatory peritoneal dialysis

CGN:

Chronic glomerulonephritis

DN:

Diabetic nephropathy

RPGN:

Rapidly progressive glomerulonephritis

CIN:

Chronic interstitial nephritis

NS:

Nephrotic syndrome

VRKD:

Vasculitis-related kidney damage

PD:

Peritoneal dialysis

ESRD:

End-stage renal disease

CRP:

C-reactive protein

VC:

Vital capacity

FVC:

Forced vital capacity

MVV:

Maximal voluntary ventilation

FEV1 :

Forced expiratory volume in the first second

PEF:

Peak expiratory flow

MMEF:

Maximal mid-expiratory flow rate

DLCO:

Diffusing capacity of the lung for carbon monoxide

Alb:

Albumin

ESR:

Erythrocyte sedimentation rate

Kt/V:

Renal urea clearance index

CCR:

Creatinine clearance rate

rGFR:

Residual glomerular filtration rate

nPNA:

Normalized protein equivalent of nitrogen appearance rate

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Acknowledgements

This study was supported by the project of Annual Research Project of Anhui Province (NO. 1208085QH172) and Key Lab of Geriatric molecular medicine of Anhui Province. We are grateful to Medjaden Bioscience Limited for assisting in the preparation of this manuscript. This study was also supported by the Natural Science Foundation of China (NO. 81170030, 81270082 and 81300027), National Education Ministry of China (NO. 20113420110006), Annual Research Project of Anhui Province (NO. 10021303028) and Key Lab of Geriatric molecular medicine of Anhui Province (1206c0805028).

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    Authors and Affiliations

    1. Department of Pulmonary, Anhui Geriatric Institute, The First Affiliated Hospital of Anhui Medical University, Jixi Road 218, Hefei, Anhui, 230022, People’s Republic of China

      Pei Zhang, Hui-Mei Wu, Qi-Ying Shen & Rong-Yu Liu

    2. Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China

      Pei Zhang & Xiang-Ming Qi

    3. Institute of Respiratory Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China

      Hui-Mei Wu, Qi-Ying Shen & Rong-Yu Liu

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    1. Pei Zhang
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    Correspondence to Rong-Yu Liu.

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    P. Zhang, H. -M. Wu, Q. -Y. Shen, X. -M. Qi contributed equally to this work.

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    Zhang, P., Wu, HM., Shen, QY. et al. Associations of pulmonary function with serum biomarkers and dialysis adequacy in patients undergoing peritoneal dialysis. Clin Exp Nephrol 20, 951–959 (2016). https://doi.org/10.1007/s10157-016-1244-1

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