Association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort study

Abstract Background Pulmonary hypertension (PH) is common in peritonealdialysis (PD) patients and is associated with increased morbidity and mortality. However, the specific risk factors for PH and its prognostic impact remain underexplored, particularly in suburban populations. This study aimed to...

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Main Authors: Yakun Wang, Wuhua Jiang, Shoujun Bai, Yingchun Zhu, Xiansheng Miao, Xiaoyan Ma, Chong Zhang, Jiarui Xu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nephrology
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Online Access:https://doi.org/10.1186/s12882-025-04198-w
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author Yakun Wang
Wuhua Jiang
Shoujun Bai
Yingchun Zhu
Xiansheng Miao
Xiaoyan Ma
Chong Zhang
Jiarui Xu
author_facet Yakun Wang
Wuhua Jiang
Shoujun Bai
Yingchun Zhu
Xiansheng Miao
Xiaoyan Ma
Chong Zhang
Jiarui Xu
author_sort Yakun Wang
collection DOAJ
description Abstract Background Pulmonary hypertension (PH) is common in peritonealdialysis (PD) patients and is associated with increased morbidity and mortality. However, the specific risk factors for PH and its prognostic impact remain underexplored, particularly in suburban populations. This study aimed to investigate the risk factors for PH and evaluate its impact on long-term all-cause and cardiovascular mortality in PD patients. Methods This single-center retrospective cohort study included adult patients who initiated PD and maintained it for at least three months at the Qingpu Branch of Zhongshan Hospital from January 2021 to December 2022. Baseline demographic, clinical, and laboratory data were collected. PH was defined as systolic pulmonary artery pressure ≥ 35 mmHg by echocardiography. Logistic regression models were used to analyze risk factors for PH, and survival outcomes were assessed using Kaplan-Meier analysis. Results Of the 103 PD patients included in the study, 29 (28.2%) were diagnosed with PH. Prealbumin levels were significantly lower in the PH group compared to the non-PH group (p = 0.007). Logistic regression analysis showed that higher prealbumin levels, whether treated as a standardized continuous variable (OR = 0.37, 95% CI: 0.18–0.76, p = 0.007) or categorized into tertiles, were consistently associated with a lower risk of PH. A significant trend across tertiles further supported this relationship (p-for-trend = 0.007). Patients with PH exhibited significantly higher all-cause mortality (31.0% vs. 6.8%, log-rank p < 0.001; HR = 5.70, 95% CI: 1.76–18.52) and cardiovascular mortality (20.7% vs. 2.7%, log-rank p < 0.001; HR = 14.94, 95% CI: 1.80–124.11). Conclusion PH is a significant predictor of all-cause and cardiovascular mortality in PD patients. These findings highlight the importance of identifying PH risk factors, particularly in suburban populations, to improve long-term outcomes in PD patients. Clinical trial number Not applicable.
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spelling doaj-art-c6eb7cd1dda148839bf6895abd1d54272025-08-20T04:01:25ZengBMCBMC Nephrology1471-23692025-07-0126111210.1186/s12882-025-04198-wAssociation between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort studyYakun Wang0Wuhua Jiang1Shoujun Bai2Yingchun Zhu3Xiansheng Miao4Xiaoyan Ma5Chong Zhang6Jiarui Xu7Department of Nephrology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan UniversityDepartment of Nephrology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan UniversityDepartment of Nephrology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan UniversityDepartment of Ultrasound, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan UniversityDepartment of Nephrology, Shanghai East Hospital Affiliated to Tongji University School of MedicineDepartment of Nephrology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineDepartment of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan UniversityAbstract Background Pulmonary hypertension (PH) is common in peritonealdialysis (PD) patients and is associated with increased morbidity and mortality. However, the specific risk factors for PH and its prognostic impact remain underexplored, particularly in suburban populations. This study aimed to investigate the risk factors for PH and evaluate its impact on long-term all-cause and cardiovascular mortality in PD patients. Methods This single-center retrospective cohort study included adult patients who initiated PD and maintained it for at least three months at the Qingpu Branch of Zhongshan Hospital from January 2021 to December 2022. Baseline demographic, clinical, and laboratory data were collected. PH was defined as systolic pulmonary artery pressure ≥ 35 mmHg by echocardiography. Logistic regression models were used to analyze risk factors for PH, and survival outcomes were assessed using Kaplan-Meier analysis. Results Of the 103 PD patients included in the study, 29 (28.2%) were diagnosed with PH. Prealbumin levels were significantly lower in the PH group compared to the non-PH group (p = 0.007). Logistic regression analysis showed that higher prealbumin levels, whether treated as a standardized continuous variable (OR = 0.37, 95% CI: 0.18–0.76, p = 0.007) or categorized into tertiles, were consistently associated with a lower risk of PH. A significant trend across tertiles further supported this relationship (p-for-trend = 0.007). Patients with PH exhibited significantly higher all-cause mortality (31.0% vs. 6.8%, log-rank p < 0.001; HR = 5.70, 95% CI: 1.76–18.52) and cardiovascular mortality (20.7% vs. 2.7%, log-rank p < 0.001; HR = 14.94, 95% CI: 1.80–124.11). Conclusion PH is a significant predictor of all-cause and cardiovascular mortality in PD patients. These findings highlight the importance of identifying PH risk factors, particularly in suburban populations, to improve long-term outcomes in PD patients. Clinical trial number Not applicable.https://doi.org/10.1186/s12882-025-04198-wPulmonary hypertensionPeritoneal dialysisPrealbuminPrognosisNutrition
spellingShingle Yakun Wang
Wuhua Jiang
Shoujun Bai
Yingchun Zhu
Xiansheng Miao
Xiaoyan Ma
Chong Zhang
Jiarui Xu
Association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort study
BMC Nephrology
Pulmonary hypertension
Peritoneal dialysis
Prealbumin
Prognosis
Nutrition
title Association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort study
title_full Association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort study
title_fullStr Association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort study
title_full_unstemmed Association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort study
title_short Association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients: a single-center retrospective cohort study
title_sort association between prealbumin levels and pulmonary hypertension in peritoneal dialysis patients a single center retrospective cohort study
topic Pulmonary hypertension
Peritoneal dialysis
Prealbumin
Prognosis
Nutrition
url https://doi.org/10.1186/s12882-025-04198-w
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