Uremic Pneumonitis

Abstract

Clinical, laboratory, and pathologic studies are presented in a case of chronic glomerulonephritis. Studies before and after 6 successive peritoneal dialyses showed improvement in each case in the extent of nitrogen retention, hyperkalemia, and metabolic acidosis. The most noteworthy observation was the repeated clearing of the pulmonary process which had the X-ray characteristics of "uremic pneumonitis"; the improvement occurred without any detectable change in cardiac hemodynamics. On 2 occasions the lung lesions disappeared, despite a positive net fluid balance following dialysis. The pathophysiology of "uremic pneumonitis" is complex and is often compounded by underlying congestive heart failure. In the present case, cardiac abnormalities were minimal; moreover, the ease with which the pulmonary process could be reversed by dialysis indicated that a specific abnormality associated with uremia may produce the entity known as uremic pneumonitis.