Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients

Etemadi, Jalal; Zolfaghari, Hajar; Firoozi, R.; Ardalan, Mohammadreza; Toufan, Mehrnoush; Shoja, Mohammadali Mohajel; Ghabili, Kamyar

doi:10.1016/j.rppneu.2011.07.002

Cited by 43 publications

(33 citation statements)

References 18 publications

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“…Although not confirmed by our results and some other studies, 6,19 current evidence is in favor of a role of AVF presence, duration, and blood flow in the pathogenesis of PAH in patients on dialysis. 3,11,20,21 Another factor that can contribute to the development of PAH by increasing cardiac output is anemia, 5,7,10,18 which was confirmed by our univariate but not multivariate analyses probably due to the small sample size. The relationship between hypoalbuminemia and sPAP, which is reported by some studies and found in our study as well, 7,10 is another factor that is probably a consequence of hypervolemia.…”

Section: Underlying Mechanisms For Pahsupporting

confidence: 59%

“…Our study showed a high prevalence of PAH among HD patients and less frequent in PD and transplant recipients. Previous studies, though reported various frequency of PAH, have indicated a significantly higher frequency of PAH in HD than in PD patients [2][3][4][5][6][7][8][9] and improvement of PAH in ESRD patients after kidney transplantation. 18 These results indicate that patients on PD and transplant recipients are at a significantly lower risk for PAH compared with patients on HD.…”

Section: Discussionmentioning

confidence: 99%

“…1 Pulmonary arterial hypertension (PAH) is another severe and progressive cardiac complication that has been recently under attention and frequently seen among ESRD patients. Studies showed a frequency of about 19% to 70% in patients on chronic hemodialysis (HD) [2][3][4][5][6][7][8][9] and 6% to 19% in patients on continuous peritoneal dialysis (PD). 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.…”

Section: Introductionmentioning

confidence: 99%

“…Studies showed a frequency of about 19% to 70% in patients on chronic hemodialysis (HD) [2][3][4][5][6][7][8][9] and 6% to 19% in patients on continuous peritoneal dialysis (PD). 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.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Underlying Mechanisms For Pahsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pulmonary Hypertension among Patients on Dialysis and Kidney Transplant Recipients

et al. 2013

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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: 54%

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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Traditional and Novel Invasive Hemodynamic Indices in the Evaluation of Congestive Heart Failure in Cardiorenal Syndrome

Shah

Patel

Agrawal

et al. 2020

Kidney Disease in the Cardiac Catheterization Laboratory

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Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients

Cited by 43 publications

References 18 publications

Pulmonary Hypertension among Patients on Dialysis and Kidney Transplant Recipients

Pulmonary Hypertension among Patients on Dialysis and Kidney Transplant Recipients

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

Traditional and Novel Invasive Hemodynamic Indices in the Evaluation of Congestive Heart Failure in Cardiorenal Syndrome

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