Prospective Study of Prevalence and Clinical Determinants of Pulmonary Hypertension in Patients on Maintenance Hemodialysis

Background and Objectives: This study was conducted to analyse the prevalence of pulmonary hypertension (PH) in maintenance haemodialysis patients, risk factors associated with it and the patient outcomes. Methods: It was a prospective observational study conducted at our centre over 2 years where 1...

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Main Authors: Jalal Ahmed, Mohammed Fahad Khan, Rohan Augustine, Vishwanath Siddini, Sudarshan Ballal
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-07-01
Series:Indian Journal of Kidney Diseases
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Online Access:https://journals.lww.com/10.4103/ijkd.ijkd_13_23
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Summary:Background and Objectives: This study was conducted to analyse the prevalence of pulmonary hypertension (PH) in maintenance haemodialysis patients, risk factors associated with it and the patient outcomes. Methods: It was a prospective observational study conducted at our centre over 2 years where 166 patients were studied. Dialysis information like dialysis vintage, Inter-dialytic weight gain, dry weight, access for dialysis and anyihypertensive use, laboratory parameters were measured. Echocardiogram was performed after dialysis after attaining dry weight and were assessed for parameters like Pulmonary artery systolic pressure (PASP), Left ventricular hypertrophy (LVH), inferior vena cava diameter at expiration, Regional wall motion abnormality (RWMA) and pericardial effusion. Results: Total number of patients with end stage kidney disease recruited was 166, of whom 97(58.4%) had PH. Among echocardiographic parameters, PH was associated with a larger left atrial diameter in end systole, a lower mean ejection fraction and lower mean mid-wall fractional shortening. The mortality rate at the end of the study period in the ESRD patients with PH was 32 % compared to 12% in those without the PH group. On multivariate analysis, female gender, inter-dialytic weight gain, dialysis vintage, dialysis access through AVF, and pericardial effusion were found to be significant predictors of PH. Conclusions: PH is a significant contributor to morbidity and mortality in patients undergoing chronic hemodialysis.
ISSN:2950-0761