| Theme |
Complications of Respiratory Organs in Dialysis Patients |
| Title |
Chronic obstructive pulmonary disease (COPD) and pulmonary metastatic calcification in chronic hemodialysis patients |
| Author |
Yaeko Murata |
Department of Blood Purification, Tohoku University Hospital |
| Author |
Toshinobu Sato |
Department of Blood Purification, Tohoku University Hospital |
| [ Summary ] |
Based on data concerning the prevalence of chronic obstructive pulmonary disease (COPD) obtained in the Nippon COPD Epidemiology study, it is estimated that about 5.3 million Japanese suffer from COPD. Patients with COPD may be more susceptible to dialysis-induced pulmonary disfunction. Guidelines for diagnosis and treatment of COPD have been created by the Japanese Respiratory Society. Spirometry is essential for diagnosis of COPD. Airflow limitation is judged to be present when the FEV1 (forced expiratory volume for one second) / FVC (forced vital capacity) ratio is less than 70 % after administration of bronchodilators. The overall approach to managing stable COPD is characterized by incremental increases in treatment, depending the severity of the disease. Pulmonary metastatic calcification is one universal complication in long-term dialysis. Pulmonary calcification is a common asymptomatic finding, however, it is often not discovered. Scintigraphy with 99mTc diphosphonate is employed to detect fine, diffuse pulmonary calcification. The mechanism of pulmonary metastatic calcification is thought to be in relation to low levels of parathyroid hormone (PTH). To prevent this complication, it is necessary to maintain serum appropriate Ca and P levels. |