IntroductionPulmonary arterial hypertension (PAH), defined as a systolic pulmonary artery pressure above 35 mm Hg, is another vascular disease entity recently described in patients receiving hemodialysis. It is a major problem due to its high prevalence and morbidity and mortality. Its pathophysiological mechanism is just known and the strategies for its supported not yet defined.AimsTo determine the prevalence of PAH in our hemodialysis patients and its risk factors.MethodologySingle center descriptive and analytical cross-sectional study, including 111 hemodialysis patients who had benefit from a trans-thoracic cardiac Doppler ultrasound during 2014. A value greater than or equal to 35 mm Hg is considered PAH and classified as follows: mild PAH (35 50 mm Hg), moderate PAH (50 70 mm Hg), and severe pulmonary hypertension (> 70 mm Hg). Patients with a high probability of secondary PAH, especially those with the following history: chronic obstructive pulmonary disease, pulmonary embolism, were not included.ResultsThe mean age was 44.3 ± 14.2 years. Among the 111 patients, 18 had pulmonary arterial pressure above 35 mm Hg corresponding to 16.22% of PAH prevalence. The average pressure was 45 mm Hg. Of these 18 patients, 11.8% had mild PAH, 3.4% moderate PAH and 0.8% severe PAH. The average hemodialysis duration was significantly associated with PAH (p = 0.003); as well as valvular calcification (p = 0.000), mitral regurgitation (p = 0.001) and tricuspid regurgitation (p = 0.002).ConclusionPrimary pulmonary hypertension is a major problem among our hemodialysis because of its high prevalence and its risk factors.
IntroductionEstimer la prévalence de la dépression et rechercher les facteurs associés chez les patients insuffisants rénaux chroniques en hémodialyse.MéthodesÉtude transversale descriptive allant du 1er Janvier 2014 au 31 Décembre 2014 à l’unité d’hémodialyse du service de Néphrologie du CHU Sylvanus Olympio de Lomé (Togo). L’échelle d’autoévaluation de la dépression de Beck dans sa version simplifiée a été notre outil d’évaluation.RésultatsDurant la période d’étude, 88 patients ont été recrutés dont 61,4% d’hommes soit un sex-ratio de 1,6. La moyenne d’âge a été de 38,80 ± 13,24 ans avec des extrêmes de 12 et 66 ans. La majorité des patients (90,9%) étaient des travailleurs. L’hypertension artérielle a été la comorbidité somatique la plus retrouvée (45,4%). Quarante-six patients (52,3%) avaient une durée en hémodialyse comprise entre 1 et 4 ans. La dépression touchait 68,2% des patients; 47,7% des patients déprimés avaient une dépression sévère. La survenue de la dépression était significativement liée à la durée en hémodialyse (p= 0,008).ConclusionLa prise en charge du patient hémodialysé chronique doit être pluridisciplinaire incluant le néphrologue et le psychiatre.
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