Risk factors for pulmonary hypertension in maintenance hemodialysis patients: a cross-sectional study.

Abstract

Pulmonary hypertension (PH) in maintenance hemodialysis (MHD) patients has attracted increasing attention. This cross-sectional survey aimed to explore PH prevalence and identify potential risk factors in MHD patients. A total of 136 MHD patients were assessed at the Fifth Affiliated Hospital of Sun Yat-sen University (China) between October 2012 and November 2014. Relevant parameters included primary disease, dialysis duration, height, weight, and interdialytic weight gain. Doppler echocardiography was performed post-hemodialysis to evaluate cardiac structure and function; fistula diameters and blood flow rates were measured by vascular ultrasound. Before and 4 weeks after echocardiography, biochemical parameters were measured. Patients were divided into PH and nPH groups, and their primary diseases were analyzed. T test and Chi-square test were used as appropriate; Pearson’s correlation and logistic regression analysis were employed to assess possible PH risk factors. PH prevalence was 38.23 % in MHD patients and 73.68 % in those with concurrent diabetes, i.e., higher than in chronic glomerulonephritis (35 %) and hypertension (33.33 %) groups. Interestingly, PH was positively correlated with left atrium, right atrium, and ventricle dimensions, and the degree of cardiac hypertrophy. In addition, diabetes and interdialytic weight gain were positively correlated with PH, while hemoglobin levels showed a negative correlation. Finally, multiple logistic regression analysis revealed interdialytic weight gain and hemoglobin as major risk factors for PH in MHD patients. PH prevalence was 38.23 % in MHD patients, a ratio increased in individuals with concurrent diabetes. Other major risk factors for PH in MHD patients include declined hemoglobin levels and increased interdialytic weight gain.