Study of pulmonary arterial hypertension in patients of chronic kidney disease stage IV and V

Abstract

Background: Pulmonary arterial hypertension (PAH) in advanced CKD patients (stage 4/5) is important to recognize, as PAH is an independent predictor of mortality in CKD patients especially those receiving renal replacement therapy and significant PH is felt to be a relative contraindication to renal transplantation. Present study was aimed to study Pulmonary Arterial Hypertension in Patients of Chronic Kidney Disease Stage 4/5 at a tertiary hospital. Material and Methods: Present study was cross-sectional, prospective and observational study, conducted patients Age ≥18 years, of either gender, diagnosed case of CKD in stage IV and stage V, underwent evaluation for PAH by echocardiography. Results: In present study, total 68 patients were included. Mean age in study was 51.93 ± 12.63 years. Male patients (73.53 %) outnumbered female patients (26.47 %). Associated Co-morbidities in present study were anemia (70.59 %), diabetes mellitus (57.35 %), systolic hypertension (32.35 %) and diastolic hypertension (26.47 %). majority of patients had stage 4 CKD (69.12 %). Mean duration of CKD was 43.11 + 26.78 weeks while mean duration of dialysis was 21.45± 15.74 weeks. 61.76 % patients had attained Dry weight in present study. In present study, incidence of pulmonary hypertension was 51.35 %. In patients with pulmonary hypertension most common etiology for CKD were diabetes mellitus (34.29%), hypertension (31.43 %), undetermined (17.14 %). In present study 47 patients (69.12 %) had stage 4 CKD. Among stage 4 patients mild PH was noted in 11 patients (16.18 %), while moderate and severe PH was noted in 4 (5.88 %) and 2 (2.94 %) patients respectively. While 21 patients (30.88 %) had stage 5 CKD. Among stage 5 patients mild PH was noted in 7 patients (10.19 %), while moderate and severe PH was noted in 5 (7.35 %) and 4 (5.88 %) patients respectively. Conclusion: Higher incidence of pulmonary hypertension is noted among chronic kidney disease and incidence increases with advanced stages.