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Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients
Poor physical performance is common in patients with kidney failure on dialysis (CKD-5D). Whether lung congestion, a predictable consequence of cardiomyopathy and fluid overload, may contribute to the low physical performance of CKD-5D patients has not been investigated in hemodialysis patients. Thi...
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| Published in: | Clinical journal of the American Society of Nephrology 2013-08, Vol.8 (8), p.1343-1348 |
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| container_title | Clinical journal of the American Society of Nephrology |
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| creator | Enia, Giuseppe Torino, Claudia Panuccio, Vincenzo Tripepi, Rocco Postorino, Maurizio Aliotta, Roberta Bellantoni, Marianna Tripepi, Giovanni Mallamaci, Francesca Zoccali, Carmine |
| description | Poor physical performance is common in patients with kidney failure on dialysis (CKD-5D). Whether lung congestion, a predictable consequence of cardiomyopathy and fluid overload, may contribute to the low physical performance of CKD-5D patients has not been investigated in hemodialysis patients.
This study investigated the relationship between the physical functioning scale of the Kidney Disease Quality of Life Short Form and a validated ultrasonographic measure of lung water in a multicenter survey of 270 hemodialysis patients studied between 2009 and 2010.
Moderate to severe lung congestion by lung ultrasonography was observed in 156 (58%) patients; among these, 60 (38%) were asymptomatic (New York Heart Association [NYHA] class I). On univariate analysis, physical functioning was inversely associated with lung water in the whole group (r=-0.22; P |
| doi_str_mv | 10.2215/CJN.11111012 |
| format | article |
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This study investigated the relationship between the physical functioning scale of the Kidney Disease Quality of Life Short Form and a validated ultrasonographic measure of lung water in a multicenter survey of 270 hemodialysis patients studied between 2009 and 2010.
Moderate to severe lung congestion by lung ultrasonography was observed in 156 (58%) patients; among these, 60 (38%) were asymptomatic (New York Heart Association [NYHA] class I). On univariate analysis, physical functioning was inversely associated with lung water in the whole group (r=-0.22; P<0.001) and in the subgroup of asymptomatic patients (r=-0.40; P=0.002). Age (r=-0.45; P<0.001) and past cardiovascular events (r=-0.22; P=0.002) were also inversely associated with physical functioning, whereas albumin (r=0.23; P<0.001) was directly associated with the same parameter. NYHA class correlated strongly with physical functioning (r=-0.52; P<0.001). In a multiple regression analysis, both NYHA class and lung water maintained an independent association with physical functioning, whereas albumin and background cardiovascular events failed to independently relate with the same outcome.
Symptomatic and asymptomatic lung congestion is associated with poor physical functioning in hemodialysis patients. This association is independent of NYHA, suggesting that this measurement and NYHA may have complementary value to explain the variability in physical performance in hemodialysis patients.</description><identifier>ISSN: 1555-9041</identifier><identifier>EISSN: 1555-905X</identifier><identifier>DOI: 10.2215/CJN.11111012</identifier><identifier>PMID: 23580785</identifier><language>eng</language><publisher>United States: American Society of Nephrology</publisher><subject>Aged ; Aged, 80 and over ; Extravascular Lung Water - metabolism ; Female ; Humans ; Logistic Models ; Lung - diagnostic imaging ; Male ; Middle Aged ; Original ; Physical Conditioning, Human ; Pulmonary Edema - physiopathology ; Renal Dialysis ; Ultrasonography</subject><ispartof>Clinical journal of the American Society of Nephrology, 2013-08, Vol.8 (8), p.1343-1348</ispartof><rights>Copyright © 2013 by the American Society of Nephrology 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-25aa0aa17606d2b88d96fcf0e416e2a5674b9653910bff6707124eaf151de8af3</citedby><cites>FETCH-LOGICAL-c416t-25aa0aa17606d2b88d96fcf0e416e2a5674b9653910bff6707124eaf151de8af3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731913/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3731913/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,4011,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23580785$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Enia, Giuseppe</creatorcontrib><creatorcontrib>Torino, Claudia</creatorcontrib><creatorcontrib>Panuccio, Vincenzo</creatorcontrib><creatorcontrib>Tripepi, Rocco</creatorcontrib><creatorcontrib>Postorino, Maurizio</creatorcontrib><creatorcontrib>Aliotta, Roberta</creatorcontrib><creatorcontrib>Bellantoni, Marianna</creatorcontrib><creatorcontrib>Tripepi, Giovanni</creatorcontrib><creatorcontrib>Mallamaci, Francesca</creatorcontrib><creatorcontrib>Zoccali, Carmine</creatorcontrib><creatorcontrib>Lung Comets Cohort Working Group</creatorcontrib><title>Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients</title><title>Clinical journal of the American Society of Nephrology</title><addtitle>Clin J Am Soc Nephrol</addtitle><description>Poor physical performance is common in patients with kidney failure on dialysis (CKD-5D). Whether lung congestion, a predictable consequence of cardiomyopathy and fluid overload, may contribute to the low physical performance of CKD-5D patients has not been investigated in hemodialysis patients.
This study investigated the relationship between the physical functioning scale of the Kidney Disease Quality of Life Short Form and a validated ultrasonographic measure of lung water in a multicenter survey of 270 hemodialysis patients studied between 2009 and 2010.
Moderate to severe lung congestion by lung ultrasonography was observed in 156 (58%) patients; among these, 60 (38%) were asymptomatic (New York Heart Association [NYHA] class I). On univariate analysis, physical functioning was inversely associated with lung water in the whole group (r=-0.22; P<0.001) and in the subgroup of asymptomatic patients (r=-0.40; P=0.002). Age (r=-0.45; P<0.001) and past cardiovascular events (r=-0.22; P=0.002) were also inversely associated with physical functioning, whereas albumin (r=0.23; P<0.001) was directly associated with the same parameter. NYHA class correlated strongly with physical functioning (r=-0.52; P<0.001). In a multiple regression analysis, both NYHA class and lung water maintained an independent association with physical functioning, whereas albumin and background cardiovascular events failed to independently relate with the same outcome.
Symptomatic and asymptomatic lung congestion is associated with poor physical functioning in hemodialysis patients. This association is independent of NYHA, suggesting that this measurement and NYHA may have complementary value to explain the variability in physical performance in hemodialysis patients.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Extravascular Lung Water - metabolism</subject><subject>Female</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lung - diagnostic imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>Physical Conditioning, Human</subject><subject>Pulmonary Edema - physiopathology</subject><subject>Renal Dialysis</subject><subject>Ultrasonography</subject><issn>1555-9041</issn><issn>1555-905X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNpVkc1PGzEQxa2qqAToredqb-2hAY8_9uNSCUWkKYogEiBxsyZeb2LktdP1LlX-exwFIvBlLL-f3njmEfIN6DljIC8m1zfnsDsU2CcyAinluKLy8fPhLuCYnMT4RKkQnMkv5JhxWdKilCNydxm37aYPLfZWZ4vBtcFjt80mwa9M7G3wGfo6W6y30Wp02XTwevdq_SqzPpuZNtQWXVJjtkgexvfxjBw16KL5-lpPycP06n4yG89v__ydXM7HWkDej5lEpIhQ5DSv2bIs6ypvdENNUg1DmRdiWeWSV0CXTZMXtAAmDDYgoTYlNvyU_N77boZla2qdenfo1KazbRpBBbTqo-LtWq3Cs-IFhwp4Mvj5atCFf0MaV7U2auMcehOGqEBAxXnFpEjorz2quxBjZ5pDG6Bql4NKOai3HBL-_f3XDvDb4hPwYw-s7Wr933ZGxRadSzhT-gmjL1WpgAvOXwCJDpK5</recordid><startdate>201308</startdate><enddate>201308</enddate><creator>Enia, Giuseppe</creator><creator>Torino, Claudia</creator><creator>Panuccio, Vincenzo</creator><creator>Tripepi, Rocco</creator><creator>Postorino, Maurizio</creator><creator>Aliotta, Roberta</creator><creator>Bellantoni, Marianna</creator><creator>Tripepi, Giovanni</creator><creator>Mallamaci, Francesca</creator><creator>Zoccali, Carmine</creator><general>American Society of Nephrology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201308</creationdate><title>Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients</title><author>Enia, Giuseppe ; Torino, Claudia ; Panuccio, Vincenzo ; Tripepi, Rocco ; Postorino, Maurizio ; Aliotta, Roberta ; Bellantoni, Marianna ; Tripepi, Giovanni ; Mallamaci, Francesca ; Zoccali, Carmine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-25aa0aa17606d2b88d96fcf0e416e2a5674b9653910bff6707124eaf151de8af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Extravascular Lung Water - metabolism</topic><topic>Female</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lung - diagnostic imaging</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>Physical Conditioning, Human</topic><topic>Pulmonary Edema - physiopathology</topic><topic>Renal Dialysis</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Enia, Giuseppe</creatorcontrib><creatorcontrib>Torino, Claudia</creatorcontrib><creatorcontrib>Panuccio, Vincenzo</creatorcontrib><creatorcontrib>Tripepi, Rocco</creatorcontrib><creatorcontrib>Postorino, Maurizio</creatorcontrib><creatorcontrib>Aliotta, Roberta</creatorcontrib><creatorcontrib>Bellantoni, Marianna</creatorcontrib><creatorcontrib>Tripepi, Giovanni</creatorcontrib><creatorcontrib>Mallamaci, Francesca</creatorcontrib><creatorcontrib>Zoccali, Carmine</creatorcontrib><creatorcontrib>Lung Comets Cohort Working Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical journal of the American Society of Nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Enia, Giuseppe</au><au>Torino, Claudia</au><au>Panuccio, Vincenzo</au><au>Tripepi, Rocco</au><au>Postorino, Maurizio</au><au>Aliotta, Roberta</au><au>Bellantoni, Marianna</au><au>Tripepi, Giovanni</au><au>Mallamaci, Francesca</au><au>Zoccali, Carmine</au><aucorp>Lung Comets Cohort Working Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients</atitle><jtitle>Clinical journal of the American Society of Nephrology</jtitle><addtitle>Clin J Am Soc Nephrol</addtitle><date>2013-08</date><risdate>2013</risdate><volume>8</volume><issue>8</issue><spage>1343</spage><epage>1348</epage><pages>1343-1348</pages><issn>1555-9041</issn><eissn>1555-905X</eissn><abstract>Poor physical performance is common in patients with kidney failure on dialysis (CKD-5D). Whether lung congestion, a predictable consequence of cardiomyopathy and fluid overload, may contribute to the low physical performance of CKD-5D patients has not been investigated in hemodialysis patients.
This study investigated the relationship between the physical functioning scale of the Kidney Disease Quality of Life Short Form and a validated ultrasonographic measure of lung water in a multicenter survey of 270 hemodialysis patients studied between 2009 and 2010.
Moderate to severe lung congestion by lung ultrasonography was observed in 156 (58%) patients; among these, 60 (38%) were asymptomatic (New York Heart Association [NYHA] class I). On univariate analysis, physical functioning was inversely associated with lung water in the whole group (r=-0.22; P<0.001) and in the subgroup of asymptomatic patients (r=-0.40; P=0.002). Age (r=-0.45; P<0.001) and past cardiovascular events (r=-0.22; P=0.002) were also inversely associated with physical functioning, whereas albumin (r=0.23; P<0.001) was directly associated with the same parameter. NYHA class correlated strongly with physical functioning (r=-0.52; P<0.001). In a multiple regression analysis, both NYHA class and lung water maintained an independent association with physical functioning, whereas albumin and background cardiovascular events failed to independently relate with the same outcome.
Symptomatic and asymptomatic lung congestion is associated with poor physical functioning in hemodialysis patients. This association is independent of NYHA, suggesting that this measurement and NYHA may have complementary value to explain the variability in physical performance in hemodialysis patients.</abstract><cop>United States</cop><pub>American Society of Nephrology</pub><pmid>23580785</pmid><doi>10.2215/CJN.11111012</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | PubMed Central Free; Highwire Press American Society of Nephrology |
| subjects | Aged Aged, 80 and over Extravascular Lung Water - metabolism Female Humans Logistic Models Lung - diagnostic imaging Male Middle Aged Original Physical Conditioning, Human Pulmonary Edema - physiopathology Renal Dialysis Ultrasonography |
| title | Asymptomatic Pulmonary Congestion and Physical Functioning in Hemodialysis Patients |
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