Duration of hemodialysis associated with cardio-respiratory dysfunction and breathlessness: a multicenter study

BACKGROUND: Patients with hemodialysis suffer with protein-energy wasting and uremic myopathy lead to lack of physical activity and poor functional performance. However, ventilation abnormality in patients undergone hemodialysis remains controversial regarding the respiratory impairment. Therefore, the study aimed to determine the effect of duration of dialysis on respiratory function. METHODS: A multicenter study with cross-sectional study was designed in four hemodialysis outpatient clinics. Respiratory muscle strength (i.e., maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP)) pulmonary function test (i.e., forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)) and FEV(1)/FVC ratio), functional capacity (6-minute walk test) and sensation of breathlessness were assessed prior to dialysis. RESULTS: A total of 100 hemodialysis patients were recruited with 38 females and 62 males. An average of duration of hemodialysis was 5.93± 4.96 years. Decreased MIP values, FEV(1) values, FVC values, %FEV(1) and %FVC were noted in patients with long duration of dialysis (defined as ≥ 5 years of dialysis) compared to those with short duration of dialysis (p(s) < .05). In addition, increased sensation of breathlessness was observed in patients with long duration of dialysis (p < .05). Furthermore, participants with long duration of dialysis had an increased risk of ventilatory restriction (OR 6.093, p = .007).