Pulmonary Arterial Hypertension and the Kidney: Getting to the Heart of the Matter

Kazory, Amir; Ross, Edward A.

doi:10.1159/000487199

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Parameters of arterial stiffness have also been associated with adverse outcomes 30 . These factors are also reported to be associated with a decline in kidney function 31,32 . The results of this study may indicate the association between these pathological features and excess IDWGL.…”

Section: Discussionmentioning

confidence: 55%

“…30 These factors are also reported to be associated with a decline in kidney function. 31,32 The results of this study may indicate the association between these pathological features and excess IDWGL. In addition to dietary sodium restriction, a longer dialysis duration or more dialysis sessions have been suggested as strategies for avoiding the potential harm of excess IDWG.…”

Section: Discussionmentioning

confidence: 56%

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Associations of interdialytic weight gain in the long intervals with mortality and residual kidney function decline

Miyasato

Hanna

Miyagi

et al. 2023

Hemodialysis International

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Introduction: Interdialytic weight gain (IDWG) is crucial in the association between long interdialytic intervals and mortality in hemodialysis patients.The impact of IDWG on changes in residual kidney function (RKF) has not been evaluated thoroughly. This study examined the associations of IDWG in the long intervals (IDWGL) with mortality and rapid RKF decline.Methods: This retrospective cohort study included patients who initiated hemodialysis in the United States dialysis centers from 2007 to 2011. IDWGL was defined as IDWG in the two-day break between dialysis sessions. This study examined the associations of seven categories of IDWGL (0% to <1%, 1% to <2%, 2% to <3% [reference], 3% to <4%, 4% to <5%, 5% to <6%, and ≥6%) with mortal-

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 56%

Associations of interdialytic weight gain in the long intervals with mortality and residual kidney function decline

Miyasato

Hanna

Miyagi

et al. 2023

Hemodialysis International

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“…Several studies have reported that GFR reduction is associated with vascular manifestations and poor prognosis [17,20,21]. In SSc-associated PH, eGFR is a strong predictor of survival, and renal impairment contributes to increased mortality [22]. In the course of PH, the increase in right atrial pressures leads to renal venous congestion with alterations of haemodynamic parameters that promote GFR reduction [23].…”

Section: Discussionmentioning

confidence: 99%

Estimated glomerular filtration rate is a marker of mortality in the European Scleroderma Trials and Research Group (EUSTAR) database

et al. 2021

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Objectives Study aim was to evaluate estimated glomerular filtration rate (eGFR), its association with clinical disease and its predictive ability with mortality in systemic sclerosis (SSc) patients from the European Scleroderma Trials and Research Group (EUSTAR) database. Methods SSc patients from the EUSTAR database with available items for calculation of eGFR at baseline visit and with a second follow-up visit were included. A cut-off of 60 ml/min was chosen for all SSc patients and 30 ml/min for scleroderma renal crisis (SRC). Cox regression and competing risk analysis were performed to evaluate the role of eGFR as predictive factor of mortality. Results 3650 SSc patients were included. Mean serum level of creatinine and eGFR were 0.8 mg/dl (IQR 0.6–0.9) and 86.6 ± 23.7 ml/min. The eGFR was significantly lower in patients with pulmonary hypertension. Overall survival (OS) was significantly reduced in SSc patients with eGFR <60 ml/min respect to patients with eGFR ≥ 60 ml/min [OS at five years 0.763 (CI 95%: 0.700–0.814) vs 0.903 (CI 95%: 0.883–0.919 p< 0.001)]. In multivariable analysis, OS was associate with male gender (p< 0.01), systolic pulmonary arterial pressure (sPAP) (p< 0.001) and eGFR (p< 0.001). Cumulative incidence of deaths due to SSc was associate with increased sPAP (p< 0.001) and reduced eGFR (p< 0.05). OS at five years of 53 SRC patients was not significantly different in SSc patients with eGFR > 30 ml/min or eGFR < 30 ml/min. Conclusion eGFR represents a predictive risk factor of overall survival in SSc. The eGFR is not a risk factor for death in SRC.

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“…Furthermore, other factors (venous congestion, inflammatory endothelial dysfunction, vasoconstrictive state, endothelin-1, interleukin-6, angiotensin and other molecules) can be involved to renal worsening correlated to PAH (30). Since PAH is a hemodinamic disease, chronic alterations of pulmonary perfusion can contribute to the reduction of the renal perfusion with slow GFR decline and increased intrarenal stiffness.…”

Section: Discussionmentioning

confidence: 99%

The Renal Resistive Index: A New Biomarker for the Follow-up of Vascular Modifications in Systemic Sclerosis

Gigante¹,

Bruni

Lepri

et al. 2020

J Rheumatol

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Objective The aim of the present retrospective observational study was to evaluate in SSc patients the change of renal resistive index (RRI) over the time (ΔRRI) and under treatment as well as to correlate these changes with disease complications. Methods 230 patients [29 male, median age 57 (48-67) years] were enrolled. At baseline and follow-up [3.43 (2.81-4.45) years] we collected following data: disease variables, nailfold videocapilloscopy (NVC) pattern, FVC (Forced vital capacity), carbon oxide diffusing capacity (DLCO), systolic pulmonary arterial pressure (sPAP), presence of interstitial lung disease, RRI, evaluation of glomerular filtration rate (eGFR), new onset of pulmonary arterial hypertension (PAH). Results RRI value is high in SSc patients with digital ulcers and ACA antibodies, active and late NVC patterns, lcSSc. A significant correlation was observed between ΔRRI and ΔsPAP (r=0.17, p=0.02), with statistically higher ΔRRI (0.08 ± 0.02 versus 0.03 ± 0.05, p=0.04) in patients complicated by PAH onset. No other new onset complication was associated with ΔRRI. The ROC curve analysis confirmed the predictive role of ΔRRI in development of new PAH (AUC 0.84; 95% CI 0.75-0.93, p=0.02). In SSc patients never exposed to sildenafil, ΔRRI was higher (0.04 ± 0.05) compared to both patients exposed to sildenafil during the study period (0.01±0.05, p=0.03) or in those exposed at the time of baseline evaluation (0.00 ± 0.05, p=0.01). Conclusion RRI and its variation in time are a reliable marker of SSc related vasculopathy, both in renal and extra-renal compartments.

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Pulmonary Arterial Hypertension and the Kidney: Getting to the Heart of the Matter

Cited by 5 publications

References 10 publications

Associations of interdialytic weight gain in the long intervals with mortality and residual kidney function decline

Associations of interdialytic weight gain in the long intervals with mortality and residual kidney function decline

Estimated glomerular filtration rate is a marker of mortality in the European Scleroderma Trials and Research Group (EUSTAR) database

The Renal Resistive Index: A New Biomarker for the Follow-up of Vascular Modifications in Systemic Sclerosis

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