Impact of chronic kidney disease on respiratory muscle strength, lung capacity, peripheral muscle strength, and functional capacity in dialysis patients: a systematic review.
Tiago Moraes, Mônica Soares de Oliveira, Beatriz Luiza Marinho Cunha et al.
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In 30 seconds
This systematic review assessed respiratory and peripheral muscle strength, pulmonary function, and functional capacity in patients with chronic kidney disease undergoing hemodialysis. It included 22 cross-sectional observational studies identified from 1266 records. Mean maximal inspiratory and expiratory pressures were 53.7 ± 19.5% and 49.5 ± 15.8% of predicted values, respectively. Handgrip strength and six-minute walk distance were also reduced relative to reference values, while pulmonary-function findings varied; restrictive ventilatory patterns were the most frequently reported abnormality.
Key findings
- Mean maximal inspiratory pressure was 53.7 ± 19.5% of predicted, and maximal expiratory pressure was 49.5 ± 15.8%.
- Maximal inspiratory pressure showed a moderate-to-strong correlation with functional capacity (r = 0.38-0.79).
- Six-minute walk distance was 66.33 ± 20.53% of predicted values.
- Pulmonary-function findings were heterogeneous; restrictive ventilatory pattern was the most frequently reported abnormality (66.7%).
Why it matters
The review indicates that impairment in hemodialysis patients may extend beyond pulmonary function to respiratory and peripheral muscle strength and overall functional capacity. These domains can be considered when assessing the broader physical burden associated with CKD. The reported correlation between inspiratory pressure and functional capacity also highlights a relationship between respiratory muscle performance and physical function, without establishing causation.
What to keep in mind
The review included cross-sectional observational studies, which cannot establish causation. Pulmonary-function findings were heterogeneous.