International Journal of Nephrology and Renovascular Disease (Dec 2021)

Risk Factors of Pulmonary Hypertension in Patients on Hemodialysis: A Single Center Study

  • Nagaraju SP,
  • Bhojaraja MV,
  • Paramasivam G,
  • Prabhu RA,
  • Rangaswamy D,
  • Rao IR,
  • Shenoy SV

Journal volume & issue
Vol. Volume 14
pp. 487 – 494

Abstract

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Shankar Prasad Nagaraju,1 Mohan V Bhojaraja,1 Ganesh Paramasivam,2 Ravindra Attur Prabhu,1 Dharshan Rangaswamy,1 Indu Ramachandra Rao,1 Srinivas Vinayak Shenoy1 1Department of Nephrology, Kasturba Medical College, Manipal, Manipal Academy Higher Education, Manipal, Karnataka, 576104, India; 2Department of Cardiology, Kasturba Medical College, Manipal, Manipal Academy Higher Education, Manipal, Karnataka, 576104, IndiaCorrespondence: Mohan V Bhojaraja Email [email protected]: Pulmonary hypertension (PH) is an underestimated cardiovascular consequence and a mortality predictor in patients on hemodialysis (HD). Thus, we studied its prevalence, risk factors, association with inflammation/oxidative stress, and cardiac changes in HD patients.Methods: This was a single-center cross-sectional observational study conducted at a tertiary care hospital. Patients aged > 18 years on hemodialysis for at least three months were included and divided into those with and without PH; patients with secondary causes for PH were excluded. Clinical characteristics, HD-related factors, lab parameters (C-reactive protein and malondialdehyde with thiol assay were used as markers of inflammation and oxidative stress, respectively), and echocardiography details were compared. PH was defined as a mean pulmonary artery pressure of > 25 mmHg at rest, and it was further divided as mild (25– 40 mmHg), moderate (40– 60 mmHg), and severe (> 60 mmHg).Results: Of 52 patients, 28 patients had PH (mild 24, moderate 4, and none had severe PH) with prevalence of 54%. No difference was found in clinical characteristics, dialysis-related factors, biochemical parameters including inflammation (C-reactive protein; p=0.76), or oxidative stress (thiol; p=0.36 and MDA; p=0.46) between the groups. When compared to individuals without PH, HD patients with PH exhibited significantly more mitral regurgitation (p=0.002).Conclusion: Hemodialysis patients have a high prevalence of PH. PH was significantly associated with the presence of mitral regurgitation on echocardiography. Our study did not find differences in traditional risk factors, HD-related factors, and inflammation/oxidative markers between the groups with and without PH.Keywords: chronic kidney disease, hemodialysis, inflammation, oxidative stress, pulmonary hypertension

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