Context: Pulmonary arterial hypertension(PH) in patients with chronic kidney disease(CKD)(on maintenance hemodialysis) indicates poor overall prognosis with increasing day-by-day incidence owing to underdiagnosis. Detection of PH warrants comprehensive evaluation which includes noninvasive assessment with physical examination and a transthoracic echocardiogram and invasive hemodynamic assessment.
Aims: To evaluate the prevalence of primary pulmonary hypertension among CKD
patients on hemodialysis and to compare clinical, hemodynamic, and metabolic variables
amongst the patients with and without PH to search for possible etiologic factors.
Settings and Design: The study was conducted at a Parul Sevashram hospital over a period of 8 months, after approval from Institutional Ethics Committee. Sixty consecutive patients undergoing regular hemodialysis for at least 3 months were studied.
Materials and Methods: All patients underwent transthoracic echocardiography one hour after dialysis to avoid overestimation of pulmonary artery pressures due to fluid overload. PH was considered as a mean right ventricular systolic pressure(RVSP) greater than 25 mmHg.
Statistical Analysis Used: Clinical, hemodynamic and metabolic variables were compared between patients with and without PH with ‘‘t’’ test. Values were expressed as mean ± Standard deviation (SD) and as percentage for categorial parameters. Nominal categorical data between the groups was compared using Chisquare test.
Results: There was a statistically very significant difference in RVSP in PH group as compared to non PH group of CKD patients.
Conclusion: Among the various complications that may arise from the chronic kidney disease, development of pulmonary hypertension portends a high cardiovascular risk and thus the increased overall morbidity and mortality.
Impact Factor
2022: 6.012
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