Prevalence of Pulmonary Hypertension in Patients Undergoing Regular Maintenance Hemodialysis due to End Stage Renal Disease

Abstract

Objectives: The aim of our study is to determine the prevalence of pulmonary hypertension in patients who undergo dialysis on a regular basis, as it has been associated with increased morbidity and mortality is the patient population. Methodology: The type of study is a cross sectional study conducted for a period of one year duration from April 2014 to March 2015, at a tertiary care hospital in Karachi, Pakistan. The study population consisted of n=90 patients with end stage renal disease, who undergo regular dialysis on maintenance basis, and had trans thoracic echocardiography performed, various parameters including the systolic pulmonary arterial pressure were recorded. A pulmonary arterial pressure greater than 30mm of Hg at rest was defined as pulmonary hypertension, and it was further divided into three sub categories mild ( btw 30-40mm of Hg ), moderate ( btw 45-65mm of Hg ), severe ( greater than 65 mm of Hg ). Variables such as age, gender, duration on maintenance dialysis, vascular access utilized were recorded. Data was analyzed using SPSS version 20. Results: Out of the total n=90 patients, n= 40 were males, and n= 50 were females, the mean duration of time duration of dialysis was 16.29 +/- 12.1 months. N= 52 patients were found to have pulmonary hypertension, and the mean value for the pulmonary arterial pressure was 38.4 +/- 19.18 mm of Hg, the mean age of patients having pulmonary hypertension was 53.45 +/- 12.4 years. Pulmonary hypertension was more common in the females as compared to the males ( n= 32 versus n= 19 ), Pulmonary hypertension was found to be greater in patients who had been on dialysis for less than 20 months duration, and it was also noticed that the longer the duration of hemodialysis the more severe the pulmonary hypertension. Conclusion: According to the results of our study patients on maintenance hemodialysis are at an increased risk of developing pulmonary hypertension, it is more common in the females, and has a strong correlation with the duration of maintenance hemodialysis and the arteriovenous access utilized.