PULMONARY FUNCTIONALITY AND ENDOTHELIAL DAMAGE AMONG PATIENTS ON KIDNEY REPLACEMENT THERAPIES

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https://storage.unitedwebnetwork.com/files/1099/2f61e77c0240f42865d1673175dfbce4.pdf

Abstract Title

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Co-author 1

Ítalo Caldas Silva italu_caldas@hotmail.com Universidade Federal do Ceará Physiotherapy Fortaleza

Co-author 2

Gdayllon Cavalcante Meneses gdayllon@yahoo.com.br Universidade Federal do Ceará Postgraduate program in Medical sciences Fortaleza

Co-author 3

Alice Maria Costa Martins martinsalice@gmail.com Universidade Federal do Ceará Clinical and Toxicological Analysis Department Fortaleza

Co-author 4

Régis Ponte Conrado regispontec@gmail.com Universidade Federal do Ceará School of Medicine Fortaleza

Co-author 5

Gabriel Magalhães Santos magalhaesgabs@gmail.com Universidade Federal do Ceará School of Medicine Fortaleza

Co-author 6

Alexandre Braga Libório alexandreliborio@yahoo.com.br Universidade Federal do Ceará Department of Clinical Medicine Fortaleza

Co-author 7

Elizabeth De Francesco Daher ef.daher@uol.com.br Universidade Federal do Ceará Department of Clinical Medicine Fortaleza

Co-author 8

Ronaldo de Matos Esmeraldo ronaldo.esmeraldo@gmail.com General Hospital of Fortaleza Kidney Transplant Section Fortaleza

Co-author 9

Nataly Gurgel Campos natgurgel@yahoo.com.br Universidade Federal do Ceará Department of Clinical Medicine Fortaleza

Co-author 10

Tainá Veras de Sandes-Freitas taina.sandes@gmail.com Universidade Federal do Ceará Department of Clinical Medicine Fortaleza

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Kidney transplantation (KT) potentially reduces pulmonary damage associated with chronic kidney disease. This study explored this assumption by comparing pulmonary functionality and endothelial function between dialysis and KT patients.

Methods

Cross-sectional study including 23 patients on dialysis for ≥24 months and 23 patients transplanted for ≥12 months, with glomerular filtration rate ≥ 40 mL/min/1.73m2, matched by gender and age. Pulmonary functionality was analyzed by maximal inspiratory and expiratory pressure (MIP and MEP), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and Tiffeneau index. Endothelial damage was assessed using syndecan-1, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule (VCAM 1), and angiopoietin-2 (Ang-2).

Results

style="font-size: 1rem; font-weight: var(--bs-body-font-weight); text-align: var(--bs-body-text-align);">Both groups had poor performance in pulmonary functionality tests. The percentage of patients reaching the predicted MIP, MEP, FEV1, and FCV was low and similar between groups (43.5%, 4.3%, 0%, and 17.4%, respectively). There were no differences in the observed/predicted MEP (66 ± 17%), FEV1 (60±18%), and FCV (76 ± 22%) ratios, and in the Tiffeneau index (0.8 [IQR 0.6-0.9] %). KT patients showed lower MIP% (82±19 vs. 94±12%, p=0.019). In KT group, endothelial damage was significantly inversely correlated with pulmonary functionality parameters, and this group presented lower levels of VCAM-1 (1,589 [IQR 1,009-1827] vs 2,302 [IQR 1,642–3,540] ng/mL, p=0.001), Ang-2 (0.17 [IQR 0.01-1.14] vs 0.75 [IQR 0.30-1.29] ng/mL, p=0.040), and Syndecan-1 (47.9 [IQR 33.1-67.8] vs 195.8 [IQR 126.9-286.8] ng/mL, p<0.001).

Conclusions

Despite better endothelial function, KT was not associated with superior pulmonary functionality, suggesting multifactorial pathophysiology for lung impairment.

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