Risk Factors of Pulmonary Hypertension in Patients on Hemodialysis: A Single Center Study

• Published in: International journal of nephrology and renovascular disease Vol. 14; pp. 487 - 494
• Main Authors: Nagaraju, Shankar Prasad, Bhojaraja, Mohan V, Paramasivam, Ganesh, Prabhu, Ravindra Attur, Rangaswamy, Dharshan, Rao, Indu Ramachandra, Shenoy, Srinivas Vinayak
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: C-reactive protein; Cardiovascular disease; Cardiovascular diseases; chronic kidney disease; Chronic kidney failure; Echocardiography; Ejection fraction; Electrocardiography; Etiology; Fistula; Health aspects; Heart; Hemodialysis; Hypertension; India; Inflammation; Kidney diseases; Laboratories; Malondialdehyde; Medical research; Medicine, Experimental; Mortality; Original Research; Oxidative stress; Patients; Peritoneal dialysis; Population; Pulmonary arteries; Pulmonary artery; Pulmonary hypertension; Regurgitation; Risk factors; Thiols; Veins & arteries; India; hemodialysis; chronic kidney disease; inflammation; pulmonary hypertension; oxidative stress
• ISSN: 1178-7058; 1178-7058
• DOI: 10.2147/IJNRD.S346184

Pulmonary hypertension (PH) is an underestimated cardiovascular consequence and a mortality predictor in patients on hemodialysis (HD). Thus, we studied its prevalence, risk factors, association with inflammation/oxidative stress, and cardiac changes in HD patients. This was a single-center cross-sectional observational study conducted at a tertiary care hospital. Patients aged >18 years on hemodialysis for at least three months were included and divided into those with and without PH; patients with secondary causes for PH were excluded. Clinical characteristics, HD-related factors, lab parameters (C-reactive protein and malondialdehyde with thiol assay were used as markers of inflammation and oxidative stress, respectively), and echocardiography details were compared. PH was defined as a mean pulmonary artery pressure of >25 mmHg at rest, and it was further divided as mild (25-40 mmHg), moderate (40-60 mmHg), and severe (>60 mmHg). Of 52 patients, 28 patients had PH (mild 24, moderate 4, and none had severe PH) with prevalence of 54%. No difference was found in clinical characteristics, dialysis-related factors, biochemical parameters including inflammation (C-reactive protein; =0.76), or oxidative stress (thiol; =0.36 and MDA; =0.46) between the groups. When compared to individuals without PH, HD patients with PH exhibited significantly more mitral regurgitation ( =0.002). Hemodialysis patients have a high prevalence of PH. PH was significantly associated with the presence of mitral regurgitation on echocardiography. Our study did not find differences in traditional risk factors, HD-related factors, and inflammation/oxidative markers between the groups with and without PH.