| Theme |
New Drugs for Dialysis Patients |
| Title |
Medicinal treatment for pulmonary diseases in chronic renal failure patients |
| Author |
Shinkichi Kameyama |
First Department of Medicine, Tokyo Women's Medical University |
| Author |
Atsushi Nagai |
First Department of Medicine, Tokyo Women's Medical University |
| [ Summary ] |
The purpose of this report is to demonstrate medicinal treatment options for essential pulmonary diseases such as bronchial asthma, chronic obstructive pulmonary disease (COPD), interstitial pneumoina and acute respiratory distress syndrome (ARDS) in patients with chronic renal failure. Asthma is accepted as a disease characterized by airway inflammation. Inhaled corticosteroids are essential in the management of asthma. Aerosolized β2-agonists are the primary therapy for acute asthma. Intravenous administration of corticosteroids is recommended for moderate to severe attacks. Bronchodilators (anticholinergics, beta agonists, and methylxanthine) may significantly reduce symptoms in COPD patients. Treatment of COPD with systemic corticosteroids significantly reduces treatment failure. Therapy for interstitial pneumonias is directed toward suppressing inflammatory processes with corticosteroids and other immunosuppressive drugs. Patients with idiopathic pulmonary fibrosis have a poorer response to therapy and prognosis than those with non-specific interstitial pneumonia and most other idiopathic interstitial pneumonias. No current evidence supports the efficacy of any particular pharmacologic therapy in reducing the mortality of patients with ARDS. Sivelestat, a neutrophil elastase inhibitor, may increase the number of ventilator-free days and reduce the number of days for ICU admission. It is not necessary to reduce the dosages of bronchodilators or corticosteroids for patients with chronic renal failure. |