Friday, November 5, 2010


Uremic lung?  is a truly forgotten entity.
A study in 1960s showed that the chest X-ray in a group of patients on ESRD were characterized by pulmonary blood stasis, interstitial edema of the lung and edematous alveoli. The pathogenesis of uremic lung was said to be related to blood urea nitrogen and creatinine retention and the concurrent presence of left side heart failure may also play a role. Hemodialysis and other comprehensive treatments could help the patients with uremic lung for relief the symptoms. 
Most people believed that the entity of uremic lung was all " fluid related" and would go away once we did fluid removal and all the lung changes were related to increased effective blood volume.
It might not be the entire story.
Apparently recent mice studies have shown that in the setting of AKI, lung vascular permeability is increased, there is dysregulated cytokines and increased IL-6 production that might lead to the entity of uremic lung. When IL-6 was blocked, the effects disappeared.
This is a real entity and dialysis is then indicated. You have to rule out cardiogenic and other causes of  pulmonary edema ofcourse


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