The potential effect of cardiac function on pulmonary hypertension, other risk factors, and its impact on survival in dialysis patients

Rroji, Merita; Cafka, Majlinda; Seferi, Saimir; Seiti, Joana; Barbullushi, Myftar; Goda, A

doi:10.1007/s11255-020-02655-z

Cited by 14 publications

(19 citation statements)

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“…Soluble urokinase plasminogen activator receptor (suPAR) and C-reactive protein (CRP) were also excellent predictors for mortality in dialysis patients[ 29 , 36 ]. SuPAR is a proteolytic cleavage product of the glycosyl-phosphatidylinositol anchor of the urokinase plasminogen activator receptor expressed on immune and endothelial cells[ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, CRP is a nonspecific acute phase reactant that can be elevated in the setting of infection or inflammatory processes[ 47 ]. Higher CRP levels are associated with pulmonary hypertension, which could represent crosstalk between inflammatory cells and pulmonary wall components[ 36 , 48 , 49 ]. Moreover, a population-based study demonstrated that CRP is independently associated with elevated parathyroid hormone levels (PTH) and increased mortality[ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rroji et al [ 36 ] added that systolic pulmonary artery pressure (PAP) is predictive for mortality in dialysis patients. Other studies have concordantly shown that pulmonary hypertension (PH) confers a significant mortality risk in dialysis patients[ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…Echocardiographic factors: The ratios of early inflow velocity/annular diastolic velocity (E/E’) through the mitral valve and the LV mass index are predictive of mortality in CKD patients, regardless of dialysis status[ 28 , 36 ]. Mitral E/E’ ratio may be a marker of LV diastolic dysfunction[ 62 ] or a predictor of pulmonary hypertension[ 36 ]. Diastolic dysfunction has been associated with increased mortality in various CKD and non-CKD patient populations[ 63 - 65 ].…”

Section: Discussionmentioning

confidence: 99%

“…PP is the difference between systolic and diastolic blood pressure. Rroji et al [ 36 ] demonstrated that PP has a significant impact on dialysis patient survival. In their study, patients with pulmonary hypertension had significantly higher PP compared with patients without pulmonary hypertension.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of mortality among patients with chronic kidney disease: A systematic review

Hansrivijit

Chen

Lnu

et al. 2021

WJN

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BACKGROUND Chronic kidney disease (CKD) is a common medical condition that is increasing in prevalence. Existing published evidence has revealed through regression analyses that several clinical characteristics are associated with mortality in CKD patients. However, the predictive accuracies of these risk factors for mortality have not been clearly demonstrated. AIM To demonstrate the accuracy of mortality predictive factors in CKD patients by utilizing the area under the receiver operating characteristic (ROC) curve (AUC) analysis. METHODS We searched Ovid MEDLINE, EMBASE, and the Cochrane Library for eligible articles through January 2021. Studies were included based on the following criteria: (1) Study nature was observational or conference abstract; (2) Study populations involved patients with non-transplant CKD at any CKD stage severity; and (3) Predictive factors for mortality were presented with AUC analysis and its associated 95% confidence interval (CI). AUC of 0.70-0.79 is considered acceptable, 0.80-0.89 is considered excellent, and more than 0.90 is considered outstanding. RESULTS Of 1759 citations, a total of 18 studies ( n = 14579) were included in this systematic review. Eight hundred thirty two patients had non-dialysis CKD, and 13747 patients had dialysis-dependent CKD (2160 patients on hemodialysis, 370 patients on peritoneal dialysis, and 11217 patients on non-differentiated dialysis modality). Of 24 mortality predictive factors, none were deemed outstanding for mortality prediction. A total of seven predictive factors [N-terminal pro-brain natriuretic peptide (NT-proBNP), BNP, soluble urokinase plasminogen activator receptor (suPAR), augmentation index, left atrial reservoir strain, C-reactive protein, and systolic pulmonary artery pressure] were identified as excellent. Seventeen predictive factors were in the acceptable range, which we classified into the following subgroups: predictors for the non-dialysis population, echocardiographic factors, comorbidities, and miscellaneous. CONCLUSION Several factors were found to predict mortality in CKD patients. Echocardiography is an important tool for mortality prognostication in CKD patients by evaluating left atrial reservoir strain, systolic pulmonary artery pressure, diastolic function, and left ventricular mass index.

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Section: Discussionmentioning

confidence: 99%