Patterns of Pulmonary Hypertension in Patients with Chronic Kidney Disease

Abstract

Background: Pulmonary hypertension (PH) is often associated with high morbidity and mortality and is recently recognized as a common complication secondary to chronic kidney disease (CKD). Epidemiological data for this disorder across the spectrum of CKD is poorly understood. Objective: The aim of the work was to detect patterns of PH in patients with chronic kidney disease (CKD). Patients and methods: This study was carried on 80 patients with CKD who were followed up at outpatient clinics, Aswan University Hospital, Aswan, Egypt. This study was conducted between February 2019 and January 2020. Results: There was highly statistically significant increase in PH (65 %) in dialytic group and (42.5%) in nondialytic group, with mean pulmonary artery systolic pressure (PASP) 41.22 ± 11.32 18 to 25 mm Hg in dialytic group versus 33.37± 9.43 mm Hg in non-dialytic group. Also, positive relationship between PH and increase in duration of CKD, but there is no significant relationship with duration of dialysis treatment, hemoglobin level, calcium and phosphorus. Despite a positive correlation between arteriovenous fistula (AVF) flow and PASP, multivariate analysis did not show a significant relation between them. Conclusion: It could be concluded that pulmonary hypertension is a common finding in CKD patients; the prevalence was highest among patients with end stage renal disease (ESRD) on regular haemodialysis (HD) than those on conservative management. Early detection of PH is important in order to avoid the serious consequences of the disease.