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Associations of pulmonary function with serum biomarkers and dialysis adequacy in patients undergoing peritoneal dialysis

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As lung impairment is an indicator of increased morbidity and mortality in patients receiving continuous ambulatory peritoneal dialysis (CAPD), the risk factors associated with impaired lung function are of great significance. The aim of this study is to elucidate the effects of inflammatory biomarkers and dialysis adequacy on pulmonary function, in CAPD patients.


101 patients undergoing CAPD, 30 CKD5 patients and 30 healthy subjects were enrolled. Spirometry and serum biomarkers were evaluated in each subject. Pulmonary function was compared among patients and control groups. Pearson analysis was used to analyze the correlation between serum biomarkers, dialysis adequacy and pulmonary function.


Lower vital capacity, maximal voluntary ventilation (MVV), forced vital capacity (FVC), peak expiratory flow (PEF), maximal mid-expiratory flow rate (MMEF), and diffusing capacity of the lung for carbon monoxide (DLCO) were observed in the CAPD group (all P < 0.05) when compared with control subjects. DLCO % was negatively correlated with CRP (r = −0.349, P = 0.007) and positively correlated with albumin (r = 0.401, P = 0.002). Total Kt/V was associated positively with MMEF % (r = 0.316, P = 0.019), and MVV % (r = 0.362, P = 0.007). nPNA was positively correlated with FVC % (r = 0.295, P = 0.049) and MMEF % (r = 0.381, P = 0.010).


The results suggest that lung function decline was directly related to higher CRP level, hypoalbuminemia, and dialysis inadequacy. These findings provide the evidence that inflammation and dialysis adequacy play a role in predicting outcomes of CAPD patients with pulmonary impairment.

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Fig. 1

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Continuous ambulatory peritoneal dialysis


Chronic glomerulonephritis


Diabetic nephropathy


Rapidly progressive glomerulonephritis


Chronic interstitial nephritis


Nephrotic syndrome


Vasculitis-related kidney damage


Peritoneal dialysis


End-stage renal disease


C-reactive protein


Vital capacity


Forced vital capacity


Maximal voluntary ventilation

FEV1 :

Forced expiratory volume in the first second


Peak expiratory flow


Maximal mid-expiratory flow rate


Diffusing capacity of the lung for carbon monoxide




Erythrocyte sedimentation rate


Renal urea clearance index


Creatinine clearance rate


Residual glomerular filtration rate


Normalized protein equivalent of nitrogen appearance rate


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This study was supported by the project of Annual Research Project of Anhui Province (NO. 1208085QH172) and Key Lab of Geriatric molecular medicine of Anhui Province. We are grateful to Medjaden Bioscience Limited for assisting in the preparation of this manuscript. This study was also supported by the Natural Science Foundation of China (NO. 81170030, 81270082 and 81300027), National Education Ministry of China (NO. 20113420110006), Annual Research Project of Anhui Province (NO. 10021303028) and Key Lab of Geriatric molecular medicine of Anhui Province (1206c0805028).

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Correspondence to Rong-Yu Liu.

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The authors have no conflict of interest to declare.

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P. Zhang, H. -M. Wu, Q. -Y. Shen, X. -M. Qi contributed equally to this work.

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Zhang, P., Wu, HM., Shen, QY. et al. Associations of pulmonary function with serum biomarkers and dialysis adequacy in patients undergoing peritoneal dialysis. Clin Exp Nephrol 20, 951–959 (2016).

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