Comparison of Pulmonary Artery Pressure before and after Kidney Transplantation in Kidney Transplant Patients with Pulmonary Hypertension

Abstract

Background: Pulmonary hypertension (PH) is a common finding in chronic kidney disease (CKD) and is associated with increased mortality and morbidity. The effect of kidney transplantation on PH is not yet well evaluated. This study aimed to compare pulmonary artery pressure (PAP) before and after kidney transplantation in CKD patients.Methods: This longitudinal study was conducted on 33 CKD patients who were candidates for kidney transplantation in a tertiary hospital in Mashhad, Iran. Pulmonary artery pressure and ejection fraction (EF) were assessed using trans-thoracic echocardiography (TTE). Demographic and clinical findings, including age, gender, and body mass index (BMI), as well as laboratory assessments, including hemoglobin, serum calcium and phosphorus level, and parathyroid hormone, were recorded before transplantation. TTE assessment was repeated one year after transplantation. Results: Mean age of the study patients (17 males and 16 females) was 30.42 ± 9.71 years. The majority of patients (85%) received hemodialysis before transplantation. Compared to before transplantation, PAP significantly decreased (from 33.67 ± 6.78 to 26.06 ± 5.78 mmHg, p<0.001) and EF increased (from 52.85 ± 7.12 to 57.03 ± 4.08, p=0.003) one year after transplantation. A significant positive correlation was found between PAP difference and EF before transplantation.Conclusions: The findings of this study showed that kidney transplantation was correlated with improved PAP and EF one year after transplantation and EF before kidney transplantation was correlated with PAP changes.

Keywords

• pulmonary hypertension
• pulmonary artery pressure
• kidney transplantation
• chronic kidney failure