Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.

<h4>Background</h4>Pulmonary hypertension (PH) was recently recognized as a common complication of end-stage renal disease (ESRD) that causes an increased risk of mortality. Epidemiological data for this disorder in earlier stages of chronic kidney disease (CKD) and its association with...

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Main Authors: Zhilian Li, Xinling Liang, Shuangxin Liu, Zhiming Ye, Yuanhan Chen, Wenjian Wang, Ruizhao Li, Lixia Xu, Zhonglin Feng, Wei Shi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0114392&type=printable
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author Zhilian Li
Xinling Liang
Shuangxin Liu
Zhiming Ye
Yuanhan Chen
Wenjian Wang
Ruizhao Li
Lixia Xu
Zhonglin Feng
Wei Shi
author_facet Zhilian Li
Xinling Liang
Shuangxin Liu
Zhiming Ye
Yuanhan Chen
Wenjian Wang
Ruizhao Li
Lixia Xu
Zhonglin Feng
Wei Shi
author_sort Zhilian Li
collection DOAJ
description <h4>Background</h4>Pulmonary hypertension (PH) was recently recognized as a common complication of end-stage renal disease (ESRD) that causes an increased risk of mortality. Epidemiological data for this disorder in earlier stages of chronic kidney disease (CKD) and its association with cardiovascular (CV) morbidity are scarce.<h4>Methods</h4>We retrospectively analyzed 2,351 Chinese CKD patients with complete clinical records and echocardiography data between Jan 2008 and May 2012. The patients were divided into the following 6 groups: CKD Stages 1-4; Stage 5 for those not on or initiated on hemodialysis for <3 months; and Stage 5D for the patients undergoing hemodialysis for ≥3 months. The prevalence of PH and CV morbidity was investigated, and their association was evaluated with a logistic regression model.<h4>Results</h4>PH was detected in 426 patients (18.1%). Mild, moderate and severe PH was diagnosed in 12.1%, 4.9% and 1.1% of the patients, respectively. Severe PH was detected in CKD Stages 5 and 5D. CV morbidity was found in 645 patients (27.4%). Compared with the non-PH group, the PH group had a higher risk for cardiac disease but not for cerebrovascular disease risk. PH severity was associated with cardiac morbidity risk [odds ratio (95% CI) for mild PH: 1.79 (1.30-2.47); moderate PH: 2.75 (1.73-4.37); severe PH: 3.90 (1.46-10.42)].<h4>Conclusions</h4>Our study showed for the first time the epidemiology profile of PH across the spectrum of CKD. Mild-to-moderate PH occurs with more frequency in advanced CKD, and severe PH is scarce in non-ESRD CKD. PH in CKD is associated with cardiac but not cerebrovascular disease, with increasing cardiac morbidity seen with increasing PH severity. Evidence from prospective studies addressing PH in this population is needed to predict cardiac events.
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spelling doaj-art-a18149fc0bcb4aa7a7d8dc3ebc87d9692025-08-20T03:01:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11439210.1371/journal.pone.0114392Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.Zhilian LiXinling LiangShuangxin LiuZhiming YeYuanhan ChenWenjian WangRuizhao LiLixia XuZhonglin FengWei Shi<h4>Background</h4>Pulmonary hypertension (PH) was recently recognized as a common complication of end-stage renal disease (ESRD) that causes an increased risk of mortality. Epidemiological data for this disorder in earlier stages of chronic kidney disease (CKD) and its association with cardiovascular (CV) morbidity are scarce.<h4>Methods</h4>We retrospectively analyzed 2,351 Chinese CKD patients with complete clinical records and echocardiography data between Jan 2008 and May 2012. The patients were divided into the following 6 groups: CKD Stages 1-4; Stage 5 for those not on or initiated on hemodialysis for <3 months; and Stage 5D for the patients undergoing hemodialysis for ≥3 months. The prevalence of PH and CV morbidity was investigated, and their association was evaluated with a logistic regression model.<h4>Results</h4>PH was detected in 426 patients (18.1%). Mild, moderate and severe PH was diagnosed in 12.1%, 4.9% and 1.1% of the patients, respectively. Severe PH was detected in CKD Stages 5 and 5D. CV morbidity was found in 645 patients (27.4%). Compared with the non-PH group, the PH group had a higher risk for cardiac disease but not for cerebrovascular disease risk. PH severity was associated with cardiac morbidity risk [odds ratio (95% CI) for mild PH: 1.79 (1.30-2.47); moderate PH: 2.75 (1.73-4.37); severe PH: 3.90 (1.46-10.42)].<h4>Conclusions</h4>Our study showed for the first time the epidemiology profile of PH across the spectrum of CKD. Mild-to-moderate PH occurs with more frequency in advanced CKD, and severe PH is scarce in non-ESRD CKD. PH in CKD is associated with cardiac but not cerebrovascular disease, with increasing cardiac morbidity seen with increasing PH severity. Evidence from prospective studies addressing PH in this population is needed to predict cardiac events.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0114392&type=printable
spellingShingle Zhilian Li
Xinling Liang
Shuangxin Liu
Zhiming Ye
Yuanhan Chen
Wenjian Wang
Ruizhao Li
Lixia Xu
Zhonglin Feng
Wei Shi
Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
PLoS ONE
title Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
title_full Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
title_fullStr Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
title_full_unstemmed Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
title_short Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
title_sort pulmonary hypertension epidemiology in different ckd stages and its association with cardiovascular morbidity
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0114392&type=printable
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