Pulmonary Hypertension in Patients Starting Peritoneal Dialysis

Orihuela, Oscar; Ventura, Ma de Jesus; Carmona-Ruiz, Héctor A; Santos-Martínez, Luis-Efrén; Sánchez, Alfonso Ramos; Paniagua, Ramón

doi:10.1016/j.arcmed.2020.02.004

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…It is speculated that chronic volume overload-induced subsequent cardiac remodeling plays a major role in the pathogenesis of PAH. Admittedly, in PD patients, both left ventricular hypertrophy and left atrial enlargement have been identified as risk factors for developing PAH [17,18].…”

Section: Introductionmentioning

confidence: 99%

The significance of volume overload in the development of pulmonary arterial hypertension in continuous ambulatory peritoneal dialysis patients

et al. 2023

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Introduction:The underlying pathophysiology of pulmonary arterial hypertension (PAH) is multifactorial; however, the significance of chronic volume overload and its subsequent effects on cardiac function must be studied thoroughly. The main objective of this study was to determine the predictive parameters of PAH in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) using transthoracic echocardiography (TTE) and bioimpedance analysis (BIA).Methods: In this cross-sectional study, 43 eligible CAPD patients were chosen. The patients were examined by TTE and BIA before the morning dialysis session, and baseline patient characteristics, echocardiography, and BIA parameters were recorded.Results: Sixteen (37.2%) patients were diagnosed with PAH. Patients with PAH had significantly greater left atrial diameter (LAD), left ventricular mass index (LVMI), and higher grades of diastolic dysfunction (DDF). Systolic pulmonary artery pressure (sPAP) correlated with LAD (p < 0.001, r = 0.566), interventricular septal diameter (IVSD) (p = 0.004, r = 0.425), LVMI (p = 0.030, r = 0.323), and extracellular water/total body water (ECW/TBW) ratio (p = 0.002, r = 0.458). Conclusion: Two volume status-related parameters including ECW/TBW ratio and inferior vena cava (IVC) expiratory diameter, and cardiac-related TTE findings such as LAD and DDF were predictors of sPAP in CAPD patients.

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Section: Introductionmentioning

confidence: 99%

The significance of volume overload in the development of pulmonary arterial hypertension in continuous ambulatory peritoneal dialysis patients

et al. 2023

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Predictors, prevalence and prognostic role of pulmonary hypertension in patients with chronic kidney disease: a systematic review and meta-analysis

Lin,

Ge,

Wang

et al. 2024

Renal Failure

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Predictive Value of Cardiopulmonary Exercise Testing Parameters for Pulmonary Arterial Hypertension in Peritoneal Dialysis Patients—A Retrospective Study

Xie,

Qiu,

Zhang

et al. 2024

Br J Hosp Med

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Aims/Background Pulmonary arterial hypertension (PAH) is a significant contributor to increased overall and cardiovascular mortality in peritoneal dialysis (PD) patients. Cardiopulmonary exercise testing (CPET) is an accurate method for measuring cardiorespiratory fitness (CRF) during both submaximal and peak exercise. Previous studies have demonstrated a strong correlation among CRF and increased cardiovascular and overall mortality rates. However, no literature currently reports the predictive value of CPET parameters for PAH occurrence in PD patients. This study primarily aims to analyze the risk factors for PAH in PD patients, assess the predictive value of CPET parameters, and provide a reference for the clinical prevention and management of PAH. Methods The clinical data of 121 PD patients who underwent CPET were retrospectively collected at Xuzhou Medical University Affiliated Hospital. Based on the event of PAH, patients were divided into two groups: a PAH group (n = 39) and a non-PAH group (n = 82). Clinical data, laboratory results, ultrasound findings, and CPET parameters were compared between the groups. Multifactorial logistic regression analysis was performed to identify the risk factors for PAH. The predictive value of CPET parameters was evaluated by calculating the area under the receiver operating characteristic (ROC) curve (AUC) using ROC curve analysis. Results White blood cell count (WBC) was an independent risk factor for PAH in PD patients (p < 0.05). VO2peak (peak oxygen uptake), VO2AT (anaerobic threshold oxygen uptake), METspeak (peak metabolic equivalents), WRpeak (peak power load) were identified as protective factors for PAH in PD patients (p < 0.05). ROC curve analysis showed that the AUC values for predicting PAH in PD patients using VO2peak, VO2AT, METspeak, and WRpeak were 0.675, 0.651, 0.719, and 0.689, respectively, with METspeak demonstrating the highest AUC for prediction. Conclusion The occurrence of PAH in PD patients is associated with WBC, VO2peak, VO2AT, METspeak, and WRpeak. Additionally, CPET parameters exhibit predictive value for PAH, with METspeak showing the highest AUC for prediction.

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Pulmonary Hypertension in Patients Starting Peritoneal Dialysis

Cited by 3 publications

References 23 publications

The significance of volume overload in the development of pulmonary arterial hypertension in continuous ambulatory peritoneal dialysis patients

The significance of volume overload in the development of pulmonary arterial hypertension in continuous ambulatory peritoneal dialysis patients

Predictors, prevalence and prognostic role of pulmonary hypertension in patients with chronic kidney disease: a systematic review and meta-analysis

Predictive Value of Cardiopulmonary Exercise Testing Parameters for Pulmonary Arterial Hypertension in Peritoneal Dialysis Patients—A Retrospective Study

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