Pulmonary Hypertension Is Associated With Reduced Patient Survival After Kidney Transplantation

Issa, Naim; Krowka, Michael J.; Griffin, Matthew D.; Hickson, La Tonya J.; Stegall, Mark D.; Cosio, Fernando G.

doi:10.1097/tp.0b013e318188d640

Cited by 134 publications

(137 citation statements)

References 23 publications

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“…Studies on non-dialysis-dependent stage 5 CKD patients reported that the prevalence of PHT ranges from 9-39% and that the prevalence of PHT is higher in patients undergoing dialysis than in nondialysis patients (9)(10)(11)(12). In the present study the prevalence of PHT in patients with stage 5 CKD not undergoing HD was 58.3%, which is higher than reported earlier (9,11,13,14). In addition, there weren't any significant differences in sPAP or the prevalence of PHT between the patients undergoing and not undergoing HD.…”

Section: Discussioncontrasting

confidence: 56%

“…Accordingly, we think in addition to CKD patients undergoing HD early-stage CKD patients should also be considered high risk patients. In most studies on patients with CKD, sPAP has been estimated as Doppler-derived sPAP and various sPAP cut offs have been used, ranging from 25 to ≥45 mmHg (9,11,(13)(14)(15). In the present study sPAP ≥35 mmHg based on Doppler echocardiography was considered diagnostic for PHT and the high prevalence of PHT in this study may be explained due to the lack of uniformity in diagnostic criteria and sPAP cutoffs in the literature.…”

Section: Discussionmentioning

confidence: 73%

See 1 more Smart Citation

Prevalence of Pulmonary Hypertension in Patients with Early Stages of Chronic Renal Disease

Yenigun¹,

Ballı²,

Turgut³

et al. 2016

Med Sci and Discov

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 73%

Prevalence of Pulmonary Hypertension in Patients with Early Stages of Chronic Renal Disease

Yenigun¹,

Ballı²,

Turgut³

et al. 2016

Med Sci and Discov

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“…2,5,8,10 Several studies showed that PAH is associated with increased mortality and poor outcomes in patients on dialysis and also after renal transplantation. 6,[11][12][13] The mechanisms underlying development of PAH in ESRD patients are still under investigation. The main mechanisms are proposed as (a) the pulmonary vascular stiffness and vasoconstriction in ESRD patients that is unable to accommodate to (b) the increased cardiac output caused by anemia, hypervolemia, and placement of an arteriovenous fistula (AVF).…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Hypertension among Patients on Dialysis and Kidney Transplant Recipients

et al. 2013

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Pulmonary arterial hypertension (PAH) is a serious cardiac complication among patients with end-stage renal disease (ESRD). We investigated pulmonary hypertension and its associated factors among patients who were on chronic dialysis and kidney transplant recipients. One hundred-eighty patients in three groups of hemodialysis (HD), peritoneal dialysis (PD), and kidney transplant were studied. Demographic and clinical characteristics and echocardiographic findings were evaluated. A multivariable linear regression model was used to find factors associated with pulmonary artery pressure. The mean age of participants was 50.3 AE 15.5 years and 63.9% were male. We found pulmonary hypertension (mean pulmonary artery pressure >25 mmHg) in 31.6%, 8.3%, and 5% of the patients on HD, PD, and transplant recipients, respectively (p < 0.001). In multivariate analyses, being on HD (B ¼ 5.276, confidence interval [CI] 95%: 1.211-9.341), age (B ¼ -0.319, CI 95%: -0.501 to -0.138), smoking (B ¼ 11.631, CI 95%: 1.847-21.416), systolic cardiac dysfunction (B ¼ 6.313, CI 95%: 3.073-9.554), and diastolic cardiac dysfunction (B ¼ 5.227, CI 95%: 1.176-9.277) were associated with systolic pulmonary artery pressure. These results showed that pulmonary hypertension is a frequent cardiac complication among patients with ESRD, and the type of renal replacement therapy (HD), systolic and diastolic cardiac dysfunction, and smoking are associated with increased pulmonary artery pressure. Further studies with larger sample sizes and also prospective studies are recommended in this regard.

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“…The prevalence of PH ranges from 9-39% in predialysis patients with stage-5 CKD (Yigla et al, 2003;Buemi et al, 2007;Havlucu et al, 2007;Abdelwhab and Elshinnawy, 2008;Issa et al, 2008), 18.8-68.8% in hemodialysis patients, and 0-42% in individuals on peritoneal dialysis therapy (Kumbar et al, 2007;Bozbas et al, 2009;Unal et al, 2009;Casas-Aparicio et al, 2010;Kiykim et al, 2010;Fabbian et al, 2011;Agarwal, 2012;Etemadi et al, 2012). In our study, 37 of 128 (28.91%) CKD patients from China, who accepted no dialysis or renal transplantation, had Doppler-derived PASP ≥ 35 mmHg.…”

Section: Discussionmentioning

confidence: 94%

Pulmonary hypertension in patients with stage 1-3 chronic kidney disease

Yang

Bao

2014

Genet. Mol. Res.

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ABSTRACT. Pulmonary hypertension (PH) secondary to chronic kidney disease (CKD) is common, but in stages 1-3 CKD patients, it remains unclear. We sought to evaluate the prevalence of PH and elucidate the possible pathogenesis in Chinese patients with early stage kidney disease. Doppler-estimated pulmonary systolic artery pressure (PASP) was measured in 101 CKD patients with glomerular filtration rate (GFR) ≥60 mL/min/1.73 m 2 and 27 CKD patients with GFR < 60 mL/min/1.73 m 2 . Echocardiographic parameters, plasma brain natriuretic peptide (BNP), and baseline characteristics of patients were recorded. PH was defined as a PASP ≥ 35 mmHg. PH prevalence was 23.76% (24/101) in GFR ≥ 60 mL/min/1.73 m 2 group and 48.15% (13/27) in GFR < 60 mL/min/1.73 m 2 group, P < 0.05. Mean lnBNP was 4.93 ± 1.60 pg/mL in 37 cases with PH and 2.89 ± 1.29 pg/mL in those without, P < 0.01. Left atrial diameter (LA) showed deviation between patients with (43.94 ± 5.81 mm) and without PH (37.76 ± 7.48 mm), P < 0.01. GFR declined significantly in PH group (44.10 ± 22.90 mL/ min/1.73 m 2 ) compared to non-PH group (75.59 ± 31.62 mL/min/1.73 m 2 ), P < 0.01. lnBNP, LA and GFR were independent determinants (r = 0.651, 0.595, -0.488, P < 0.01) of PASP. PH is prevalent among stage 1-3 CKD patients in China. Doppler-estimated PASP is strongly associated with lnBNP, enlarged LA and GFR. Monitoring PASP, plasma BNP and evaluation renal function may help to detect and

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Pulmonary Hypertension Is Associated With Reduced Patient Survival After Kidney Transplantation

Abstract: These analyses suggest for the first time that pretransplant PH correlates with patient survival after kidney transplantation.

Cited by 134 publications

References 23 publications

Prevalence of Pulmonary Hypertension in Patients with Early Stages of Chronic Renal Disease

Prevalence of Pulmonary Hypertension in Patients with Early Stages of Chronic Renal Disease

Pulmonary Hypertension among Patients on Dialysis and Kidney Transplant Recipients

Pulmonary hypertension in patients with stage 1-3 chronic kidney disease

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