Impact of Elevated Parathormone Levels on the Severity of Pulmonary Hypertension in Patients with End Stage Renal Disease Undergoing Hemodialysis

Tudoran, Cristina; Tudoran, Mariana; Mateş, Ancuţa; Pop, Gheorghe Nicusor; Abu-Awwad, Ahmed

doi:10.37358/rc.20.1.7848

Cited by 7 publications

(10 citation statements)

References 17 publications

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“…In some studies patients with MAU showed a higher prevalence of concentric than eccentric LVH [26]. Prevalence of CKD (13.32%) of albuminuria and reduced eGFR in hypertensive patients was similar to other studies [27][28][29][30][31]. To reduce the burden of CKD and HMOD by hypertension screening programmes and by development of public primary care health strategies, lower blood pressure and risk factors, represented a priority of the present research.…”

Section: Left Ventricular Hypertrophysupporting

confidence: 81%

“…LVH is an important risk factor for atrial fibrillation, diastolic and systolic heart failure, arrhythmias and sudden death [24][25][26][27]. Studies have demonstrated that concentric left ventricular hypertrophy implies the highest CV risk and that angiotensin converting enzyme inhibitors favour regression of both LVH and albuminuria [25][26][27][28]. In some studies patients with MAU showed a higher prevalence of concentric than eccentric LVH [26].…”

Section: Left Ventricular Hypertrophymentioning

confidence: 99%

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Biochemical and Paraclinical Evaluation of Organ Damage in Arterial Hypertension with Associated Chronic Kidney Disease

Baaj¹,

Abu-Awwad²,

Botoca³

et al. 2020

Rev. Chim.

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Organ damages, which contribute to the overall cardiovascular risk of hypertensive patients, should be early detected, prevented and treated. The study evaluated organ damage in a hypertensive study group with chronic kidney disease (CKD), compared with a study group of hypertension without CKD. Albuminuria was present in 41.2% and reduced estimated glomerular filtration rate [60 ml/min/m2 was present in 72.5% of hypertensive with CKD. The comparison of organ damage revealed in the CKD group a statistical significant higher prevalence of organ damage as follows: intima-media thickness ]0.9 mm in 39.9% vs 10.5%, carotid plaques in 28.2% vs 12.6%, left ventricular hypertrophy in 39.9% vs 31%, ankle brachial index in 6.2% vs 3.5%. Early detection and treatment of additional cardiovascular risk factors as dyslipidaemia and hyperglycaemia, that have significant role in the pathogenesis of organ damage, contribute to the better prevention of cardiovascular and renal complications in hypertension with CKD.

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Section: Left Ventricular Hypertrophysupporting

confidence: 81%

Section: Left Ventricular Hypertrophymentioning

confidence: 99%

Biochemical and Paraclinical Evaluation of Organ Damage in Arterial Hypertension with Associated Chronic Kidney Disease

Baaj¹,

Abu-Awwad²,

Botoca³

et al. 2020

Rev. Chim.

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“…Patients with PH had higher AVF blood flow, 1150 (1000–1410) mL/min versus 980 (892.5–1150) mL/min, p < 0.001. 12 Therefore, when the SPAP was >45 mmHg and the flow of AVF was higher. It suggested that the AVF function was better.…”

Section: Discussionmentioning

confidence: 97%

“…1 Pulmonary artery pressure (PAP) in MHD patients was significantly related to AVF blood flow. 11,12 After the establishment of AVF, the circulation returned volume and cardiac output were increased sharply, which led to an increase in PAP.…”

Section: Introductionmentioning

confidence: 99%

Impact of pulmonary hypertension on arteriovenous fistula failure of hemodialysis patients: A 10 years follow-up cohort study

et al. 2021

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Background: Pulmonary hypertension (PH) is common in patients with end-stage renal disease (ESRD). Arteriovenous fistulas (AVF) creation may involve in the pathogenesis of PH. The aim of this study was to explore the impact of PH after AVF creation on the AVF failure rate in maintenance hemodialysis (MHD) patients. Methods: From January 1, 2009, to January 1, 2019, we retrospectively collected data of 578 MHD patients in Guangdong Provincial People’s Hospital Blood Purification Center, China. Patients were followed-up until AVF failure or death or May 25, 2020. According to the systolic pulmonary artery pressure (SPAP) within 1 year after the establishment of AVF, the MHD patients were divided into three groups: SPAP ⩽ 35 mmHg, 35 < SPAP < 45 mmHg, SPAP ⩾ 45 mmHg. The primary outcome was AVF failure defined as AVF cannot complete hemodialysis. The secondary outcomes were all-cause mortality. Results: A total of 578 patients were analyzed. The average age was 60.66 ± 15.34 years (58.1% men). Of these, 26.1% of patients were reported PH. The SPAP exhibited a left-skewed nonparametric distribution and the overall SPAP after the creation of AVF was 39.00 (29.00–52.00) mmHg. The median follow-up was 5.8 (5.5–6.3) years. Overall, 12.8% (74/578) patients were reported AVF failure events. There was no significant difference in AVF failure rate among three groups ( p = 0.070). A total of 111 (19.2%) died during the follow-up period. Compared with the SPAP ⩽35 mmHg group, only the all-cause death rate significantly increased in MHD patients with PH ( p < 0.001). Conclusions: The secondary pulmonary hypertension after AVF creation did not increase the risk of AVF failure in MHD patients, but significantly increased the risk of mortality for this portion of the patients. Future larger sample sizes, multi-center, and prospective trials are needed to make sure which type of access will benefit on their survival for MHD patients with SPAP ⩾35 mmHg.

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“…In a small prospective research of 12 patients, Yigla et al 13 showed the influence of increasing cardiac output (CO) after AVF creation on the rise of pulmonary arterial pressure (PAP). Afzal et al 11 mentioned in a recent article that among the factors contributing to the development of PH, AVF could be one of the causes of unexplained elevated PAP. Other researchers, on the other hand, discovered no link between AVF flow rates and development of PH similar to our finding.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Pulmonary Hypertension in Patients on Hemodialysis: A Single Center Study

Nagaraju¹,

Bhojaraja²,

Paramasivam³

et al. 2021

IJNRD

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Introduction Pulmonary hypertension (PH) is an underestimated cardiovascular consequence and a mortality predictor in patients on hemodialysis (HD). Thus, we studied its prevalence, risk factors, association with inflammation/oxidative stress, and cardiac changes in HD patients. Methods This was a single-center cross-sectional observational study conducted at a tertiary care hospital. Patients aged >18 years on hemodialysis for at least three months were included and divided into those with and without PH; patients with secondary causes for PH were excluded. Clinical characteristics, HD-related factors, lab parameters (C-reactive protein and malondialdehyde with thiol assay were used as markers of inflammation and oxidative stress, respectively), and echocardiography details were compared. PH was defined as a mean pulmonary artery pressure of >25 mmHg at rest, and it was further divided as mild (25–40 mmHg), moderate (40–60 mmHg), and severe (>60 mmHg). Results Of 52 patients, 28 patients had PH (mild 24, moderate 4, and none had severe PH) with prevalence of 54%. No difference was found in clinical characteristics, dialysis-related factors, biochemical parameters including inflammation (C-reactive protein; p =0.76), or oxidative stress (thiol; p =0.36 and MDA; p =0.46) between the groups. When compared to individuals without PH, HD patients with PH exhibited significantly more mitral regurgitation ( p =0.002). Conclusion Hemodialysis patients have a high prevalence of PH. PH was significantly associated with the presence of mitral regurgitation on echocardiography. Our study did not find differences in traditional risk factors, HD-related factors, and inflammation/oxidative markers between the groups with and without PH.

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Impact of Elevated Parathormone Levels on the Severity of Pulmonary Hypertension in Patients with End Stage Renal Disease Undergoing Hemodialysis

Cited by 7 publications

References 17 publications

Biochemical and Paraclinical Evaluation of Organ Damage in Arterial Hypertension with Associated Chronic Kidney Disease

Biochemical and Paraclinical Evaluation of Organ Damage in Arterial Hypertension with Associated Chronic Kidney Disease

Impact of pulmonary hypertension on arteriovenous fistula failure of hemodialysis patients: A 10 years follow-up cohort study

Risk Factors of Pulmonary Hypertension in Patients on Hemodialysis: A Single Center Study

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