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Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study

Muscle wasting is associated with increased mortality and morbidity in chronic kidney disease (CKD) patients, especially in the haemodialysis (HD) population. Nevertheless, little is known regarding diaphragm dysfunction in HD patients. We conducted a cross-sectional study at the Institute of Nephro...

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Autores principales: Wang, Bin, Yin, Qing, Wang, Ying-yan, Tu, Yan, Han, Yuchen, Gao, Min, Pan, Mingming, Yang, Yan, Xue, Yufang, Zhang, Li, Zhang, Liuping, Liu, Hong, Tang, Rining, Zhang, Xiaoliang, xiao, Jingjie, Wang, Xiaonan H., Liu, Bi-Cheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920450/
https://www.ncbi.nlm.nih.gov/pubmed/31853002
http://dx.doi.org/10.1038/s41598-019-56035-4
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author Wang, Bin
Yin, Qing
Wang, Ying-yan
Tu, Yan
Han, Yuchen
Gao, Min
Pan, Mingming
Yang, Yan
Xue, Yufang
Zhang, Li
Zhang, Liuping
Liu, Hong
Tang, Rining
Zhang, Xiaoliang
xiao, Jingjie
Wang, Xiaonan H.
Liu, Bi-Cheng
author_facet Wang, Bin
Yin, Qing
Wang, Ying-yan
Tu, Yan
Han, Yuchen
Gao, Min
Pan, Mingming
Yang, Yan
Xue, Yufang
Zhang, Li
Zhang, Liuping
Liu, Hong
Tang, Rining
Zhang, Xiaoliang
xiao, Jingjie
Wang, Xiaonan H.
Liu, Bi-Cheng
author_sort Wang, Bin
collection PubMed
description Muscle wasting is associated with increased mortality and morbidity in chronic kidney disease (CKD) patients, especially in the haemodialysis (HD) population. Nevertheless, little is known regarding diaphragm dysfunction in HD patients. We conducted a cross-sectional study at the Institute of Nephrology, Southeast University, involving 103 HD patients and 103 healthy volunteers as normal control. Ultrasonography was used to evaluate diaphragmatic function, including diaphragm thickness and excursion during quiet and deep breathing. HD patients showed lower end-inspiration thickness of the diaphragm at total lung capacity (0.386 ± 0.144 cm vs. 0.439 ± 0.134 cm, p < 0.01) and thickening fraction (TF) (0.838 ± 0.618 vs. 1.127 ± 0.757; p < 0.01) compared to controls. The velocity and excursion of the diaphragm were significantly lower in the HD patients during deep breathing (3.686 ± 1.567 cm/s vs. 4.410 ± 1.720 cm/s, p < 0.01; 5.290 ± 2.048 cm vs. 7.232 ± 2.365 cm; p < 0.05). Changes in diaphragm displacement from quiet breathing to deep breathing (△m) were lower in HD patients than in controls (2.608 ± 1.630 vs. 4.628 ± 2.110 cm; p < 0.01). After multivariate adjustment, diaphragmatic excursion during deep breathing was associated with haemoglobin level (regression coefficient = 0.022; p < 0.01). We also found that the incidence of dyspnoea and hiccup and the fatigue scores, all of which were related to diaphragmatic dysfunction, were significantly higher in HD patients than in controls (all p < 0.01). Improving diaphragm function through targeted therapies may positively impact clinical outcomes in HD patients.
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spelling pubmed-69204502019-12-20 Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study Wang, Bin Yin, Qing Wang, Ying-yan Tu, Yan Han, Yuchen Gao, Min Pan, Mingming Yang, Yan Xue, Yufang Zhang, Li Zhang, Liuping Liu, Hong Tang, Rining Zhang, Xiaoliang xiao, Jingjie Wang, Xiaonan H. Liu, Bi-Cheng Sci Rep Article Muscle wasting is associated with increased mortality and morbidity in chronic kidney disease (CKD) patients, especially in the haemodialysis (HD) population. Nevertheless, little is known regarding diaphragm dysfunction in HD patients. We conducted a cross-sectional study at the Institute of Nephrology, Southeast University, involving 103 HD patients and 103 healthy volunteers as normal control. Ultrasonography was used to evaluate diaphragmatic function, including diaphragm thickness and excursion during quiet and deep breathing. HD patients showed lower end-inspiration thickness of the diaphragm at total lung capacity (0.386 ± 0.144 cm vs. 0.439 ± 0.134 cm, p < 0.01) and thickening fraction (TF) (0.838 ± 0.618 vs. 1.127 ± 0.757; p < 0.01) compared to controls. The velocity and excursion of the diaphragm were significantly lower in the HD patients during deep breathing (3.686 ± 1.567 cm/s vs. 4.410 ± 1.720 cm/s, p < 0.01; 5.290 ± 2.048 cm vs. 7.232 ± 2.365 cm; p < 0.05). Changes in diaphragm displacement from quiet breathing to deep breathing (△m) were lower in HD patients than in controls (2.608 ± 1.630 vs. 4.628 ± 2.110 cm; p < 0.01). After multivariate adjustment, diaphragmatic excursion during deep breathing was associated with haemoglobin level (regression coefficient = 0.022; p < 0.01). We also found that the incidence of dyspnoea and hiccup and the fatigue scores, all of which were related to diaphragmatic dysfunction, were significantly higher in HD patients than in controls (all p < 0.01). Improving diaphragm function through targeted therapies may positively impact clinical outcomes in HD patients. Nature Publishing Group UK 2019-12-18 /pmc/articles/PMC6920450/ /pubmed/31853002 http://dx.doi.org/10.1038/s41598-019-56035-4 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Wang, Bin
Yin, Qing
Wang, Ying-yan
Tu, Yan
Han, Yuchen
Gao, Min
Pan, Mingming
Yang, Yan
Xue, Yufang
Zhang, Li
Zhang, Liuping
Liu, Hong
Tang, Rining
Zhang, Xiaoliang
xiao, Jingjie
Wang, Xiaonan H.
Liu, Bi-Cheng
Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study
title Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study
title_full Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study
title_fullStr Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study
title_full_unstemmed Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study
title_short Diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study
title_sort diaphragmatic dysfunction associates with dyspnoea, fatigue, and hiccup in haemodialysis patients: a cross-sectional study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920450/
https://www.ncbi.nlm.nih.gov/pubmed/31853002
http://dx.doi.org/10.1038/s41598-019-56035-4
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