|Breathlessness and respiratory disability post renal transplantation
|Farrell AM, Baqer N, Kant S, Farrelly S, Hunt E, Clarkson MR, Henry MT, Kennedy MP, Plant WD, Plant B.J, Eustace J, Murphy DM.
|Cork University Hospital
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|General Respiratory and Sleep
|Dyspnea is a common complaint in patients with end stage kidney disease being treated with dialysis. Symptoms often persist post renal transplant. The aim of this study was to assess a cohort of renal allograft recipients for potential respiratory compromise, hence identifying a potential target for therapeutic intervention.
Renal transplant patients under active follow-up in a single tertiary referral center, were asked to partake in this cross-sectional study at time of clinic follow up. Patients who consented completed the Medical Research Council (MRC) Dyspnea Score and performed basic spirometry. An MRC score ≥2 and/or a forced expiratory volume in one second <90% prompted formal clinical assessment by a Respiratory Physician. 103 patients were enrolled in this study.
35% of all patients reported breathlessness and, with the combined evaluation, 56% of all patients warranted formal respiratory medicine review. Following completion of their investigations, 33 patients were found to have an underlying condition accounting for their symptoms.
We recommend that structured evaluation utilising the MRC Dyspnea Score and spirometry be incorporated into the routine follow-up of renal transplant recipients, as this study has indicated a substantial burden of disease that is not ascertained by non-systematic clinical review. Furthermore, it may be prudent to consider this in potential renal transplant recipients prior to transplantation.