Enliven: Nephrology and Renal Studies

The Correlation Between Nitric Oxide Levels and Spirometry in Dialyzed Patients Compared to Healthy Subjects
Author(s): Pedja Kovacevic, Sasa Dragic, Zvezdana Rajkovaca, Tijana Kovacevic

Several studies demonstrated increase in plasma concentration of nitric oxide (NO) in dialyzed patients (hemodialysis - HD and peritoneal dialysis - CAPD) compared to healthy control subjects. However, the effects of NO on respiratory function in these patients are less known. The aim of this study was to determine the potential differences in spirometry related to the serum levels of NO.

The study included 28 patients (15 males, mean age 55.9 ±16, 2 years) with end stage renal diseases receiving regular HD, 23 patients (10 males, mean age 55.8 ±15,8 years) treated with CAPD without any cardiovascular and respiratory diseases, and 30 healthy volunteers (14 males, mean age 51.8 ±15,6 years) in control group. The values of spirometry parameters were recorded in all studied patients. Serum levels of NO were measured by Griess reaction.

In groups of patients who were treated with HD or CAPD we found statistically significant difference in values of most pulmonary function parameters between subjects with NO level lower than 9,5 μmol/L and subjects with NO higher than 9,5 μmol/L. In the control group there was no difference in pulmonary function parameters in correlation to NO levels. NO values in patients of both dialyzed groups were significantly higher compared to healthy subjects. Grater level of NO in dialyzed patients than in healthy subject is associated with lower parameters of lung function tests. This can be explained by progression of inflammation, pulmonary oedema also known as “uraemic lung”or/and the progression of pulmonary hypertension.