Pulmonary Function Test Abnormalities in Patients of Chronic Kidney Disease at a Tertiary Care Hospital of Lahore

Muhammad Ahmad; Arslan Iqbal; Saba Fatima; Umair Arshad; Sami Ullah Mumtaz; Sundus Rauf

doi:10.70302/jpsim.v6i2.2533

Original Research

Pulmonary Function Test Abnormalities in Patients of Chronic Kidney Disease at a Tertiary Care Hospital of Lahore

Muhammad Ahmad¹

Central Park Medical College Teaching Hospital Lahore

Arslan Iqbal¹

Central Park Medical College Teaching Hospital Lahore

Saba Fatima¹

Central Park Medical College Teaching Hospital Lahore

Umair Arshad²

Narowal Medical College, DHQ Teaching Hospital, Narowal

Sami Ullah Mumtaz²

Narowal Medical College, DHQ Teaching Hospital, Narowal

Sundus Rauf¹

Central Park Medical College Teaching Hospital Lahore

✉ Correspondence: Muhammad Ahmad Email: doctor.ahmad84@gmail.com

DOI https://doi.org/10.70302/jpsim.v6i2.2533

Volume: 6, Issue 2 Pages: 175–179 Published: 05 Jun 2025

Received: 14 Oct 2024 Revised: 10 Jan 2025 Accepted: 25 Apr 2025 Published Online: 05 Jun 2025

Abstract

Objectives

To evaluate the pulmonary function test abnormalities in patients of chronic kidney disease (CKD).

Methods

This prospective study was conducted at the Department of Pulmonology and Critical Care, Central Park Teaching Hospital, Lahore, from June 2023 to December 2023. A total of 61 patients were enrolled after getting an informed consent. Spirometry pulmonary function tests were done for all enrolled patients before and after hemodialysis.

Results

Out of the total 61 patients, there were 28 male (45.9%) and 33 (54.1%) female participants with a mean age of 45.40±8.45 years. The mean FVC% of the enrolled patients before hemodialysis was 47.8 ± 27.9% and after hemodialysis was 58.2±5.2% with a statistically significant P-value. The mean FEV1% of the enrolled patients before hemodialysis was 40.24±2.37% and after hemodialysis was 48.2±4.2% with a statistically significant P-value. The mean FEV1/FVC (%) of the enrolled patients before hemodialysis was 68.0±2.70% and after hemodialysis was 81.9±1.9% with a statistically significant P-value. The mean FEF 25-75% of the enrolled patients before hemodialysis was 53.34±2.46% and after hemodialysis was 57.8±2.1% with a statistically significant P-value. The mean PEF% of the enrolled patients before hemodialysis was 46.8±3.3% and after hemodialysis was 51.7±2.7% with a statistically significant P-value.

Conclusion

We concluded that there were significant improvements in pre- and post-hemodialysis spirometry parameters. Therefore, this study will help the clinical practitioner to consider treatment strategies keeping in mind the comorbidities in CKD patients.

Keywords

Pulmonary function abnormalities CKD Hemodialysis BMI Forced vital capacity Peak expiratory flow rate.

How to Cite This Article

Ahmad M, Iqbal A, Fatima S, Arshad U, Mumtaz SU, Rauf S. Pulmonary Function Test Abnormalities in Patients of Chronic Kidney Disease at a Tertiary Care Hospital of Lahore. J Pak Soc Intern Med. 2025;6(2):175–179. doi:10.70302/jpsim.v6i2.2533

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

Bollenbecker S, Czaya B, Gutierrez OM, Krick S. Lung-kidney interactions and their role in chronic kidney disease-associated pulmonary diseases. Am J Physiol Lung Cel Mol Physiol. 2022;322(5):L625-L40.
Naqvi SB, Collins AJ. Infectious complications in chronic kidney disease. Advan Chron Kidney Dis. 2006;13(3):199-204.
Jafar TH. The growing burden of chronic kidney disease in Pakistan. New Eng J Med. 2006;354(10):995.
Amin A, Jamil M, Ahmad A, Amjad A, Khan Z, Khaliq SU. Assesment of Quality of Life in Patients Undergoing Hemodialysis in RMI, Peshawar. Pak J Med Health Sci. 2022;16(07):808-.
Combe C, McCullough KP, Asano Y, Ginsberg N, Maroni BJ, Pifer TB. Kidney disease outcomes quality initiative (K/DOQI) and the dialysis outcomes and practice patterns study (DOPPS): nutrition guidelines, indicators, and practices. Am J Kidney Dis. 2004;44:39-46.
Ullah K, Butt G, Masroor I, Kanwal K, Kifayat F. Epidemiology of chronic kidney disease in a Pakistani population. Saudi J Kidney Dis Transplant. 2015;26(6):1307.
Faria RdS, Fernandes N, Lovisi JCM, Reboredo MdM, Marta MSdM, Pinheiro BdV, et al. Pulmonary function and exercise tolerance are related to disease severity in pre-dialytic patients with chronic kidney disease: a cross-sectional study. BMC Nephrol. 2013;14:1-8.
Rocha CBJ, Araújo S. Evaluation of maximum respiratory pressures in chronic renal paients at the pre and post hemodialysis moment. Braz J Nephrol. 2010;32:107-13.
Kalender B, Erk M, Pekpak MA, Apaydın S, Ataman R, Serdengeçti K, et al. The effect of renal transplantation on pulmonary function. Nephron. 2002;90(1):72-7.
Hasan AM, Alashkar AM, Esmael NF, Ibrahim AAE. Assessment of pulmonary function in end stage renal disease patients on regular hemodialysis. Egypt J Hospital Med. 2019;76(1):3319-23.
Hekmat R, Boskabady M, Khajavi A, Nazary A. The effect of hoemodialysis on pulmonary function tests and respiratory symptoms in patients with chronic renal failure. Pak J Med Sci. 2007;23(6):862.
Herrington WG, Smith M, Bankhead C, Matsushita K, Stevens S, Holt T, et al. Body-mass index and risk of advanced chronic kidney disease: Prospective analyses from a primary care cohort of 1.4 million adults in England. PloS one. 2017;12(3):e0173515.
Vivante A, Golan E, Tzur D, Leiba A, Tirosh A, Skorecki K, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med. 2012;172(21):1644-50.
Hsu C-y, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006;144(1):21-8.
Mahmoud BL, Abdulkader A, El-Sharkawy M, Khalil HH. Assessment of pulmonary functions in chronic renal failure patients with different haemodialysis regimens. J Egypt Soc Parasitol. 2004;34(3):1025-40.
Sim YS, Lee J-H, Lee W-Y, Suh DI, Oh Y-M, Yoon J-s, et al. Spirometry and bronchodilator test. Tuberc Resp Dis. 2017;80(2):105-12.
Talasz H, Kofler M, Kalchschmid E, Pretterklieber M, Lechleitner M. Breathing with the pelvic floor? Correlation of pelvic floor muscle function and expiratory flows in healthy young nulliparous women. In Urogynecol J. 2010;21:475-81.
Sharma A, Sharma A, Gahlot S, Prasher PK. A study of pulmonary function in end-stage renal disease patients on hemodialysis: a cross-sectional study. Sao Paulo Med J. 2017;135:568-72.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.

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[1] Bollenbecker S, Czaya B, Gutierrez OM, Krick S. Lung-kidney interactions and their role in chronic kidney disease-associated pulmonary diseases. Am J Physiol Lung Cel Mol Physiol. 2022;322(5):L625-L40.

[2] Naqvi SB, Collins AJ. Infectious complications in chronic kidney disease. Advan Chron Kidney Dis. 2006;13(3):199-204.

[3] Jafar TH. The growing burden of chronic kidney disease in Pakistan. New Eng J Med. 2006;354(10):995.

[4] Amin A, Jamil M, Ahmad A, Amjad A, Khan Z, Khaliq SU. Assesment of Quality of Life in Patients Undergoing Hemodialysis in RMI, Peshawar. Pak J Med Health Sci. 2022;16(07):808-.

[5] Combe C, McCullough KP, Asano Y, Ginsberg N, Maroni BJ, Pifer TB. Kidney disease outcomes quality initiative (K/DOQI) and the dialysis outcomes and practice patterns study (DOPPS): nutrition guidelines, indicators, and practices. Am J Kidney Dis. 2004;44:39-46.

[6] Ullah K, Butt G, Masroor I, Kanwal K, Kifayat F. Epidemiology of chronic kidney disease in a Pakistani population. Saudi J Kidney Dis Transplant. 2015;26(6):1307.

[7] Faria RdS, Fernandes N, Lovisi JCM, Reboredo MdM, Marta MSdM, Pinheiro BdV, et al. Pulmonary function and exercise tolerance are related to disease severity in pre-dialytic patients with chronic kidney disease: a cross-sectional study. BMC Nephrol. 2013;14:1-8.

[8] Rocha CBJ, Araújo S. Evaluation of maximum respiratory pressures in chronic renal paients at the pre and post hemodialysis moment. Braz J Nephrol. 2010;32:107-13.

[9] Kalender B, Erk M, Pekpak MA, Apaydın S, Ataman R, Serdengeçti K, et al. The effect of renal transplantation on pulmonary function. Nephron. 2002;90(1):72-7.

[10] Hasan AM, Alashkar AM, Esmael NF, Ibrahim AAE. Assessment of pulmonary function in end stage renal disease patients on regular hemodialysis. Egypt J Hospital Med. 2019;76(1):3319-23.

[11] Hekmat R, Boskabady M, Khajavi A, Nazary A. The effect of hoemodialysis on pulmonary function tests and respiratory symptoms in patients with chronic renal failure. Pak J Med Sci. 2007;23(6):862.

[12] Herrington WG, Smith M, Bankhead C, Matsushita K, Stevens S, Holt T, et al. Body-mass index and risk of advanced chronic kidney disease: Prospective analyses from a primary care cohort of 1.4 million adults in England. PloS one. 2017;12(3):e0173515.

[13] Vivante A, Golan E, Tzur D, Leiba A, Tirosh A, Skorecki K, et al. Body mass index in 1.2 million adolescents and risk for end-stage renal disease. Arch Intern Med. 2012;172(21):1644-50.

[14] Hsu C-y, McCulloch CE, Iribarren C, Darbinian J, Go AS. Body mass index and risk for end-stage renal disease. Ann Intern Med. 2006;144(1):21-8.

[15] Mahmoud BL, Abdulkader A, El-Sharkawy M, Khalil HH. Assessment of pulmonary functions in chronic renal failure patients with different haemodialysis regimens. J Egypt Soc Parasitol. 2004;34(3):1025-40.

[16] Sim YS, Lee J-H, Lee W-Y, Suh DI, Oh Y-M, Yoon J-s, et al. Spirometry and bronchodilator test. Tuberc Resp Dis. 2017;80(2):105-12.

[17] Talasz H, Kofler M, Kalchschmid E, Pretterklieber M, Lechleitner M. Breathing with the pelvic floor? Correlation of pelvic floor muscle function and expiratory flows in healthy young nulliparous women. In Urogynecol J. 2010;21:475-81.

[18] Sharma A, Sharma A, Gahlot S, Prasher PK. A study of pulmonary function in end-stage renal disease patients on hemodialysis: a cross-sectional study. Sao Paulo Med J. 2017;135:568-72.