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.rppnen.2011.12.002

Cited by 8 publications

(12 citation statements)

References 19 publications

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“…Bozbas et al reported a PH ratio of 18.8% in HD patients compared with 5.9% in PD patients [13]. Etemadia et al reported results (41.1% vs.18.7%) consistent with those of Bozbas et al [14]. In contrast, Zhang et al found no difference in PH between HD and PD patients (37.5% vs. 31.8%) [15].…”

Section: Discussionmentioning

confidence: 81%

Pulmonary hypertension in end-stage renal disease patients on dialysis and predialysis patients

Zhang

Wang

et al. 2020

CIM

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Purpose: Pulmonary hypertension (PH) is a frequent and serious cardiovascular complication in patients with end-stage renal disease (ESRD) on dialysis. The purpose of this study was to investigate the prevalence of PH and its associated factors in patients with ESRD on maintenance dialysis and predialysis patients. Methods: The medical records of ESRD patients who underwent kidney transplantation between January 2011 and December 2017 were retrospectively reviewed. Demographic and clinical characteristics including echocardiographic findings before joining the waiting list for transplantation were evaluated and compared among groups divided according to dialysis or not and dialysis types. The results of transthoracic Doppler echocardiography were used to determine the pulmonary artery pressure. Pulmonary hypertension was defined as a systolic pulmonary artery pressure (sPAP) greater than 35 mmHg. Univariate and multivariate analyses were used to investigate factors associated with PH. Results: Data from 35 pre-dialysis patients with ESRD, 72 maintenance hemodialysis (HD) and 34 peritoneal dialysis (PD) patients were analysed. Pulmonary hypertension was 20.69% in pre-dialysis patients, 16.7% in HD patients and 14.7% in PD patients (P=0.957). There were negative correlations between sPAP and calcium (r=-0.230, P=0.012), Ca×P(r=-0.210, P=0.021), hemoglobin (r=-0.243, P=0.008) and a positive correlation between sPAP and cardiac output (r=0.481, P=0.000). Cardiac output (CO) was an independent risk factor of sPAP (B=1.431, confidence interval [CI] 95%: 0.687 to 2.175, P=0.000). Conclusion: Incidence of PH was not statistically different in ESRD patients on dialysis and pre-dialysis patients. Uremia may play a major role in the pathogenesis of PH in patients.

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Section: Discussionmentioning

confidence: 81%

Pulmonary hypertension in end-stage renal disease patients on dialysis and predialysis patients

Zhang

Wang

et al. 2020

CIM

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“…Quanto à prevalência de HAP em pacientes com DRC em hemodiálise, um estudo realizado por Alhamad et al 8 apresentou prevalência semelhante ao encontrado neste estudo, pois, entre 12 doentes renais crônicos terminais, 21,8% tinham HAP (medidas pelo ecocardiograma), embora só tenham sido consideradas medidas de PSAP ≥ 40 mmHg. Outros estudos também encontraram prevalência de HAP maior que a do presente estudo, como os de Zhao et al 15 (38,5% em 70 pacientes de Chengdu, na China), Etemadi et al 16 (41,1% em 34 pacientes de Tabriz, no Irã) e Mukhtar et al 17 (56% em 80 pacientes de Karachi, no Paquistão).…”

Section: Discussionunclassified

“…Entre as principais comorbidades identificadas, destacam-se a HAS (95,5%) e a diabetes mellitus (50,0%). Estudos como o de Etemadi et al 16 revelaram média de PSAP de 37,5 (35-45) mmHg, sem variações quanto ao gênero, com acesso vascular por meio de fístula arteriovenosa e um tempo de início da terapia de hemodiálise considerável, em média 102 semanas. Os estudos de Mukhtar et al 17 19 , descreveram a presença da fístula arteriovenosa como um dos principais mecanismos que podem explicar a HAP em pacientes submetidos à hemodiálise, por aumentar o retorno venoso ao lado direito do coração, resultando em um aumento do débito de saída do ventrículo direito e sobrecarga da vasculatura.…”

Section: Discussionunclassified

“…Em 2016, um estudo analisou as tendências relacionadas à HAP em adultos, nos Estados Unidos, e demonstrou que a hipertensão arterial (5,1-17,1%), a diabetes (4,6-7,8%) e a doença coronariana (15,6-22,3%) são comorbidades frequentemente associadas. A insuficiência cardíaca congestiva (40,7-56,1%) e a doença renal aguda (5,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20),1%) e crônica (1,1-16,4%) também aparecem como fatores importantes 22 .…”

Section: Discussionunclassified

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Hipertensão pulmonar em pacientes com doença renal crônica terminal internados em um hospital de referência em nefrologia do estado do Pará, Brasil

Sousa

Oliveira

Moreira

et al. 2018

Revista Pan-Amazônica de Saúde

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Hipertensão pulmonar em pacientes com doença renal crônica terminal internados em um hospital de referência em nefrologia do estado do Pará, Brasil Pulmonary hypertension in hospitalized patients with chronic end-stage kidney disease at a referral hospital in nephrology in Pará State, Brazil RESUMO OBJETIVOS: Verificar a existência de hipertensão arterial pulmonar (HAP) entre os pacientes portadores de doença renal crônica (DRC) em hemodiálise e identificar seus perfis clínicos. MATERIAIS E MÉTODOS: Estudo retrospectivo, realizado por meio da análise de prontuários de pacientes internados em um hospital de referência em nefrologia do estado do Pará, Brasil, de janeiro a dezembro de 2014. Pela aplicação de um questionário, foram analisados idade, gênero, comorbidades, motivo da internação, tipo de acesso vascular e informações do ecocardiograma Doppler transtorácico, como a medida da pressão sistólica da artéria pulmonar (PSAP), considerando-se valores ≥ 35 mmHg sugestivos de HAP. RESULTADOS: Dos 101 pacientes investigados, 21,8% apresentavam sinais sugestivos de HAP. Desses, 63,6% pertenciam ao gênero masculino, com média de idade de 60,36 ± 12,35 anos. Constatou-se média de PSAP de 51,13 ± 11,40 mmHg e a maioria das internações foram motivadas por uremia (45,5%) e síndrome coronariana aguda (13,6%). Entre as comorbidades, destacaram-se a hipertensão arterial sistêmica (95,5%) e a diabetes mellitus (50,0%). A maioria dos pacientes usava um acesso vascular de curta permanência do tipo Shilley (95,5%) para hemodiálise, e o desfecho mais reportado foi o óbito (36,4%). CONCLUSÃO: O rastreamento de HAP por ecocardiograma pode ser útil para a avaliação cardiopulmonar entre os pacientes urêmicos, havendo necessidade de estudos prospectivos para melhor esclarecer a relação entre HAP e a terapia de hemodiálise em portadores de DRC.Palavras-chave: Doença Renal Crônica; Hemodiálise; Hipertensão Pulmonar.ABSTRACT OBJECTIVES: To verify the existence of pulmonary arterial hypertension (PAH) among patients with chronic kidney disease (CKD) undergoing hemodialysis, and to identify their clinical profiles. MATERIALS AND METHODS: A retrospective study was carried out by analyzing the medical records of patients admitted to a referral hospital in nephrology in Pará State, Brazil, from January to December 2014. Variables as age, gender, comorbidities, reason for hospitalization, type of vascular access were obtained by a questionnaire and analyzed. In addition, transthoracic Doppler echocardiography information, such as pulmonary artery systolic pressure (PASP), with values ≥ 35 mmHg suggesting PAH, was considered. RESULTS: From the total of 101 patients investigated, 21.8% presented signs suggestive of PAH, and 63.6% of those were male with mean age of 60.36 ± 12.35 years. Mean PASP was 51.13 ± 11.40 mmHg and the majority of hospitalizations were due to uremia (45.5%) and acute coronary syndrome (13.6%). Among the main comorbidities identified, systemic arterial hypertension (95.5%) and diabetes mellitus (50.0%) stand out. Most of ...

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“…The presence of PH in ESRD is an independent risk factor and decreases the survival likelihood among HD patients [3]. The prevalence of PH in ESRD patients having AVF ranges between 27% and 58% [4]. PH among ESRD patients is a multifactorial process, and echocardiography has a limited ability to define the particular contribution of cardiac output (CO), pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR) to the elevated PAP [5][6].…”

Section: Introductionmentioning

confidence: 99%

Association of Pulmonary Hypertension With End-Stage Renal Disease Among the Obese Population

Jameel

Junejo

Ejaz

et al. 2020

Cureus

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Unexplained pulmonary hypertension in peritoneal dialysis and hemodialysis patients

Cited by 8 publications

References 19 publications

Pulmonary hypertension in end-stage renal disease patients on dialysis and predialysis patients

Pulmonary hypertension in end-stage renal disease patients on dialysis and predialysis patients

Hipertensão pulmonar em pacientes com doença renal crônica terminal internados em um hospital de referência em nefrologia do estado do Pará, Brasil

Association of Pulmonary Hypertension With End-Stage Renal Disease Among the Obese Population

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