P1520pulmonary Hypertension as New Risk Factor for Mortality in Hemodialysis

Abstract

Background and Aims The prevalence of pulmonary hypertension HTP in patients receiving dialysis therapy is not completely clear, it is an independent risk factor for cardiovascular mortality, which indicates the serious need to sensitize the clinic with this comorbidity and maintain an active search for it. Objective: Raise awareness about the prevalence of HTP in a hemodialysis population and identify the associated risk factors. Method Descriptive, retrospective study, in which echocardiograms of the patient (peritoneal dialysis PD and hemodialysis HD) in renal facility were reviewed, at least 12 months in therapy, Nice 2013 classification were used for the diagnosis of HTP, multivariate analysis (echocardiograHTPic, demograHTPic, clinical and biochemical variables) was performed and the statistical significance of P <0.05 with the X2 method was searched for the associated risk factors. Results 24 male patients (45%), 75% with systemic hypertension, 34% with diabetes mellitus T2, on average 5 years on dialysis (+/- 2.7), age of 64 years (+/- 13.6) and 3 very elderly patients (> 85y); 35 patients (66%) on hd and 18 (34%) on PD. 51% had fistula ArterioVenosa (FAV). 100% of patients in hd with KtVe> 1.25 and 73% in pd with KtV> 1.7. Regarding the HTP, 27 positive patients were found (51%), the significant (p <0.05), were: hd 54% vs 44% PD, having a 76% central catheter with HTP vs 33% with fav, and patients with severe vs mild Hiperparatiroidism The severity of HTP, in hd vs pd was more severe, PSP average of pressures in the positive 43mmHg vs 34.3mmHg respectively (p <0.033) Conclusion HTP is a comorbidity that impoverishes the cardiovascular prognosis and its management must be specific, especially due to the preference of calcium antagonists over the use of renin angiotensin system blockers. The prevalence of PHT in the hemodialysis population is very high, which makes the clinician an active search and effective treatment, especially in patients with catheters. Hyperparathyroidism plays a role within the remodeling mechanisms of the pulmonary arterial endothelium, aggravating this situation and increasing mortality