The Incidence and Severity of Pulmonary Hypertension among Patients with Chronic Kidney Disease
DOI:
https://doi.org/10.47672/ejhs.1371Keywords:
Pulmonary hypertension, chronic kidney disease, dialysis.Abstract
Purpose: Chronic kidney disease (CKD) is a major health problem and is closely linked with cardiovascular disease. Pulmonary hypertension (PH) is considered a common comorbidity in CKD patients. This study aimed at assessing the correlation between CKD and pulmonary hypertension.
Methodology: This is a retrospective study that recruited 100 Egyptian patients with stage 3 and above Chronic Kidney Disease (CKD) (KDOQI guidelines). The study sample was composed of 100 patients with 60% overall prevalence of PH. Transthoracic echo Doppler study was performed to measure pulmonary artery systolic pressure based on tricuspid jet in the sample.
Findings: There was significant association between PH and severity of renal disease. The hemodialysed group showed a higher prevalence of PH with a more severe PH compared to groups not on regular dialysis. The study had provided evidence that PH is a common comorbidity in CKD patients and is directly proportional with the stage and duration of CKD.
Recommendations: Pulmonary hypertension should be regularly assessed using echocardiography in CKD patients specially those on regular dialysis.
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-Saran R, Robinson B, Abbott KC, Bragg-Gresham J, Chen X, Gipson D,et al. US Renal Data System 2019 Annual Data Report: Epidemiology of Kidney Disease in the United States( USRDS. 2019). Am J Kidney Dis. 2020;75(A6-A7).
- Navaneethan SD, Roy J, Tao K, Brecklin CS, Chen J, Deo R, et al. Prevalence, predictors, and outcomes of pulmonary hypertension in CKD. J Am Soc Nephrol 2016; 27(3): 877-886.
- Ramasubbu K, Deswal A, Herdejurgen C, Aguilar D, Frost AE, et al. A prospective echocardiographic evaluation of pulmonary hypertension in chronic hemodialysis patients in the United States: prevalence and clinical significance. Int J Gen Med 2010; 3: 279-286.
- Agarwal R. Prevalence, determinants and prognosis of pulmonary hypertension among hemodialysis patients. Nephrol Dial Transplant 2012; 27(10): 3908-3914.
- Selvaraj S, Shah SJ, Ommerborn MJ, et al. Pulmonary hypertension is associated with a higher risk of heart failure hospitalization and mortality in patients with chronic kidney disease: The Jackson Heart Study. Circ Heart Fail 2017;10(6): e003940.
-Hostetter TH, Olson JL, Rennke HG, VENKATACHALAM MA, et al. Hyperfiltration in remnant nephrons: a potentially adverse response to renal ablation. J. Am. Soc. Nephrol. 2001 Jun;12(6):1315-1325.
- Levey AS, Coresh J, Bolton K, Culleton B, Harvey KS, Ikizler TA, Johnson CA, Kausz A, et al. National Kidney Foundation KDOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification Am J Kidney Dis, 39 (2002), pp. S1-266
- Levey AS, Stevens LA, Coresh J, Zhang YL, Castro AF 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604-612.
- Levey AS, Stevens LA, Conceptual model of CKD: applications and implications Am J Kidney Dis, 53 (2009), pp. S4-16
- Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Chronic Kidney Disease Epidemiology Collaboration. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006 Aug 15;145(4):247-254.
-Inker LA, Astor BC, Fox CH, Isakova T, Lash JP, Peralta CA, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am. J. Kidney Dis. 2014 May;63(5):713-735.
-Moniruzzaman M, Islam MN, Alam MB, Khan MH, Ali Z, Chowdhury AW, et al. Pulmonary Hypertension in Hemodialysis Patients. Cardiovasc J 2012; 4:148"‘152.
Matsushita K, van der Velde M, et al. Chronic Kidney Disease Prognosis Consortium, Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet 2010;375:2073-2081.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY, et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351:1296-1305.
- Esam H. Alhamad, Mohammed Al-Ghonaim, Alfaleh HF, Cal JP, Said N, et al. Pulmonary hypertension in end-stage renal disease and post renal transplantation patients. J thoracic disease 2014;6(6) :606-616.
- Kawar B, Ellam T, Jackson, Kiely DG, et al. Pulmonary hypertension in renal disease: epidemiology, potential mechanisms and implications .Am J Nephrol 2013;37:281-290.
-Tarrass F, Benjelloun M, Hachim K, Benghanem MG, Ramdani B et al. Pulmonary hypertension in patients with end"‘stage renal disease. Indian J Nephrol 2005;15:223"‘226.
- Patel P, Abraham G, Pratap P, Ramalakshmiet R, Mathew M, Jeevan JM, et al. Clinical and Biochemical parameters in Chronic Kidney Disease with Pulmonary Hypertension. Indian J of Nephrol 2007;17:4"‘6.
- Nakhoul F, Yigla M, Gilman R, Reisner SA, Abassi Z, et al. The pathogenesis of pulmonary hypertension in haemodialysis patients via arteriovenous access. Nephrol Dial Transplant 2005;20:1686"‘1692.
Domenici A, Luciani R, Principe F. Pulmonary hypertension in dialysis patients. Peritoneal Dialysis Int 2010;30:251"‘252.
-Mazdeh MM, Mousavi SA, Yahyazadeh H, Azadi M, Yoosefnejad H, Ataiipoor Y, et al. Pulmonary hypertension in hemodialysis patients. Saudi J Kidney Dis Transpl 2008;19:189"‘193.
-Li Z, Liang X, Liu S, Ye Z, et al. PulmonaryHypertension: Epidemiology in Different CKD Stages and Its Association with Cardiovascular Morbidity. PLoS One 2014;9:e114392.
-Yang QM, Bao XR. Pulmonary hypertension in patients with stage 1"‘3 chronic kidney disease. Genet Mol Res 2014;13:5695"‘703.
-Sise ME, Courtwright AM, Channick RN. Pulmonary hypertension in patients with chronic and end"‘stage kidney disease. Kidney Int 2013;84:682"‘692.
-Bolignano D, Rostelli S, Agarwal R, Fliser D, Massy Z, Ortiz A, et al. Pulmonary Hypertension in CKD. Am J Kidney Dis 2013;61:612"‘622.
-Havlucu Y, Kursat S, Ekmekci C, Celik P, Serter S, Bayturan O, et al. Pulmonary hypertension in patients with chronic renal failure. Respiration 2007;74:503"‘510.
-Fabbian F, Cantelli S, Molino C, et al. Pulmonary hypertension in dialysis patients: A cross"‘sectional Italian study. Int J Nephrol 2010;11:463"‘75.Elsevier; 2011:1706"‘1707.
-Tiengo A, Fadini GP, Avogaro A. The metabolic syndrome, diabetes and lung dysfunction. Diabetes Metab 2008;34:447"‘454
-Ramasubbu K, Deswal A, Herdejurgen C, Aguilar D, Frost AE, et al. A prospective echocardiographic evaluation of pulmonary hypertension in chronic hemodialysis patients in the United States: Prevalence and clinical significance. Int J Gen Med 2010;3:279"‘286.
-Kiykim AA, Horoz M, Ozcan WT, Yildiz I, Sari S, Genctoy G, et al. Pulmonary hypertension in hemodialysis patients without arteriovenous fistula: The effect of dialyzer composition. Ren Fail 2010;32:1148"‘1152.
-Emara MM, Habeb MA, Alnahal AA, Elshazly TA, Alatawi FO, Masoud AS, et al. Prevalence of pulmonary hypertension in patients with chronic kidney disease on and without dialysis. Egypt JChest Tuberculosis 2013;62:761"‘768.
- Abassi Z, Nakhoul F, Khankin E, Reisner SA, Yigla M, et al. Pulmonary hypertension in chronic dialysis patients with arteriovenous fistula: Pathogenesis and therapeutic prospective. Curr Opin Nephrol Hypertens 2006;15:353"‘560.
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Copyright (c) 2023 Mamdouh Maher, Hany Fayed, Ahmed Ali, Ahmed Zaid, Ahmed Magdy
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