Pulmonary Hypertension in Dialysis Patients

Oygar, Düriye Deren; Zekican, Guzin

doi:10.3109/0886022x.2012.690715

Cited by 12 publications

(5 citation statements)

References 27 publications

(42 reference statements)

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“…Additionally, diabetes was significantly more prevalent among patients with PAH. In line with our results, previous reports revealed that hypertensive nephropathy was the main underlying cause of nephropathy in which its incidence was significantly different among individuals with and without pulmonary hypertension [9,16,22,23]. One potential reason is that individuals with chronic hypertension often develop left ventricular hypertrophy, and studies have shown a probable link between LVH and an increased risk of PAH [24].…”

Section: Discussionsupporting

confidence: 90%

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: Discussionsupporting

confidence: 90%

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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“…Despite some conflicting results, evidence suggests that anemia can contribute to pulmonary hypertension by aggravating hypoxia and increasing cardiac output in patients with ESRD [ 8 , 9 ]. Interestingly, we observed significantly lower hemoglobin levels in patients with PAH than in those without PAH [ 20 , 29 , 30 ]. The low levels of hemoglobin in HD patients with PAH might be a result of hypervolemia.…”

Section: Discussionmentioning

confidence: 99%

The Relationship of Fluid Overload as Assessed by Bioelectrical Impedance Analysis with Pulmonary Arterial Hypertension in Hemodialysis Patients

et al. 2016

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BackgroundPulmonary arterial hypertension (PAH) is common disease among hemodialysis (HD) patients and is associated with increased morbidity and mortality. However, its pathogenesis has not been completely elucidated. We aimed to evaluate the frequency of PAH in HD patients, as well as the relationship between fluid status and PAH.Material/MethodsWe enrolled 77 HD patients in this study. Multifrequency bioimpedance analysis (BIA) was used to assess fluid status. BIA was performed before and 30 min after the midweek of HD. Overhydration (OH)/extracellular water (ECW)% ratio was used as an indicator of fluid status. Fluid overload was defined as OH/ECW ≥7%. Echocardiographic examinations were performed before and after the HD. Pulmonary arterial hypertension was defined as systolic pulmonary artery pressure at rest (sPAP) higher than 35 mmHg.ResultsPAH was found in 33.7% of the HD patients. OH/ECW and the frequency of fluid overload were significantly higher in HD patients with PAH than those without PAH, whereas serum albumin and hemoglobin levels were significantly lower. sPAP level was significantly higher in HD patients with fluid overload than in those without fluid overload after hemodialysis session. Furthermore, sPAP, OH/ECW levels, and the frequency of PAH were significantly reduced after HD. We also found a significant positive correlation between sPAP and OH/ECW. Multivariate logistic regression analysis demonstrated fluid overload to be an independent predictor of PAH after HD.ConclusionsPAH is prevalent among HD patients. This study demonstrated a strong relationship between fluid overload and PAH in HD patients.

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“…However, in most trials, PAP measurements are obtained by Doppler echocardiography due to its noninvasive nature. 2,22,23 In conclusion, the present study indicated that pulmonary hypertension was a common condition in ESRD patients undergoing hemodialysis. However, we were not able to detect a significant association between PAP and the SF-36 domains.…”

Section: Discussionmentioning

confidence: 85%

“…21 Thus, measurement of HRQOL should be included in the general clinical work-up and follow-up of patients on dialysis. 22,23 In this study, we assessed the relation between pulmonary hypertension and HRQOL in patients undergoing hemodialysis. Significant differences were observed among our study groups regarding the physical function, physical role, bodily pain, general health, vitality, social function, emotional role, mental health, and physical component summary.…”

Section: Discussionmentioning

confidence: 99%

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2016

Exp Clin Transplant

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Objectives: Pulmonary hypertension has been reported to occur in a considerable proportion of patients with end-stage renal disease. End-stage renal disease affects the health-related quality of life of patients. There is a lack of specific information on the relation between pulmonary hypertension and health-related quality of life in patients with end-stage renal disease in the literature. We aimed to evaluate this relation in patients undergoing hemodialysis. Materials and Methods: This prospective case-control study included 68 patients treated with hemodialysis and 30 healthy participants as controls. Group 1 comprised hemodialysis patients with pulmonary hypertension, group 2 comprised patients without pulmonary hypertension, and group 3 were healthy subjects. Each patient's health-related quality of life was measured with the Medical Outcomes Study 36-Item Short Form health survey. Doppler echocardiography was performed to determine pulmonary artery pressure in all patients. The groups were compared with respect to health-related quality of life. Results: Pulmonary hypertension was found in 47.1% of patients (mean systolic pulmonary artery pressure of 48.9 ± 11.8 mmHg). Significant differences were observed among the 3 groups regarding the physical function, physical role, bodily pain, general health, vitality, social function, emotional role, mental health, and physical component summary (P = .001). There was no significant correlation between pulmonary artery pressure and health survey scores. Conclusions: Hemodialysis patients had significantly lower quality of life scores than healthy subjects. There were no significant differences in terms of health survey domains between the hemodialysis patients with and without pulmonary hypertension. This may be due to the severe adverse effects of end-stage renal disease on health-related quality of life. We conclude that, because end-stage renal disease has so many adverse effects on health-related quality of life, the additional effects of pulmonary hypertension on health-related quality of life could not be revealed.

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Pulmonary Hypertension in Dialysis Patients

Cited by 12 publications

References 27 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

The Relationship of Fluid Overload as Assessed by Bioelectrical Impedance Analysis with Pulmonary Arterial Hypertension in Hemodialysis Patients

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