Document Detail


Pulmonary congestion and physical functioning in peritoneal dialysis patients.
MedLine Citation:
PMID:  22942271     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Decline in physical function is commonly observed in patients with kidney failure on dialysis. Whether lung congestion, a predictable consequence of cardiomyopathy and fluid overload, may contribute to the low physical functioning of these patients has not been investigated.
METHODS: In 51 peritoneal dialysis (PD) patients, we investigated the cross-sectional association between the physical functioning scale of the Kidney Disease Quality of Life Short Form (KDQOL-SF: Rand Corporation, Santa Monica, CA, USA) and an ultrasonographic measure of lung water recently validated in dialysis patients. The relationship between physical functioning and lung water was also analyzed taking into account the severity of dyspnea measured using the New York Heart Association (NYHA) classification currently used to grade the severity of heart failure.
RESULTS: Evidence of moderate-to-severe lung congestion was evident in 20 patients, and this alteration was asymptomatic (that is, NHYHA class I) in 11 patients (55%). On univariate analysis, physical functioning was inversely associated with lung water (r = -0.48, p < 0.001), age (r = -0.44, p = 0.001), previous cardiovascular events (r = -0.46, p = 0.001), and fibrinogen (r = -0.34, p = 0.02). Physical functioning was directly associated with blood pressure, the strongest association being with diastolic blood pressure (r = 0.38, p = 0.006). The NYHA class correlated inversely with physical functioning (r = -0.51, p < 0.001). In multiple regression analysis, only lung water and fibrinogen remained independent correlates of physical functioning. The NYHA class failed to maintain its independent association.
CONCLUSIONS: This cross-sectional study supports the hypothesis that symptomatic and asymptomatic lung congestion is a relevant factor in the poor physical functioning of patients on PD.
Authors:
Giuseppe Enia; Rocco Tripepi; Vincenzo Panuccio; Claudia Torino; Maurizio Garozzo; Giovanni Giorgio Battaglia; Carmine Zoccali
Publication Detail:
Type:  Journal Article     Date:  2012-09-01
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  32     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:    2012 Sep-Oct
Date Detail:
Created Date:  2012-09-19     Completed Date:  2013-03-14     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  531-6     Citation Subset:  IM    
Affiliation:
Nephrology, Dialysis, Hypertension and Renal Transplantation Unit, Azienda Ospedaliera, Reggio Calabria, Italy. enia1951@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure
Cross-Sectional Studies
Dyspnea / diagnosis*
Echocardiography
Female
Humans
Kidney Failure, Chronic / physiopathology*,  therapy
Male
Motor Activity
Peritoneal Dialysis / adverse effects*
Pulmonary Edema / etiology*,  ultrasonography
Quality of Life*
Regression Analysis
Risk Factors
Severity of Illness Index
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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