What is the clinical evidence from this study?

Study design: Cohort. Population: Pulmonary hypertension in maintenance hemodialysis (n=179). Intervention: Pulmonary hypertension vs. Absence of pulmonary hypertension. Primary outcome: All-cause hospitalization in non-elderly patients (HR 2.24, 95% CI 1.26-3.98, p=0.006).

What question did this study set out to answer?

This research examines the differences in the prevalence and risk factors of pulmonary hypertension (PH) between non-elderly and elderly patients undergoing maintenance hemodialysis.

May 8, 2026Open Access

Difference in risk profiles for pulmonary hypertension between non-elderly and elderly patients undergoing maintenance hemodialysis

Key Result

The presence of pulmonary hypertension significantly increased the risk of all-cause hospitalization (HR 2.24) in non-elderly patients undergoing maintenance hemodialysis.

Key Points

This research examines the differences in the prevalence and risk factors of pulmonary hypertension (PH) between non-elderly and elderly patients undergoing maintenance hemodialysis.
Included 179 maintenance hemodialysis patients with clinical records.
Evaluated patients using Doppler echocardiography to measure pulmonary artery systolic pressure.
Statistical analysis included areas under the receiver operating characteristic curves.
Prevalence of PH was 24.8% in non-elderly and 33.8% in elderly patients.
Presence of PH increased all-cause hospitalization risk significantly in non-elderly patients (HR: 2.24, 95% CI 1.26-3.98, P = 0.006).
Risk factor analysis identified serum NT-proBNP and diabetes mellitus as key predictors for the respective age groups.

Study Design

Type

Cohort (n=179)

Multicenter

Structured PICO

Population

179 adults with end-stage renal disease undergoing maintenance hemodialysis thrice weekly for at least 3 months, median age 55.00 years. Comprising 105 non-elderly (<60 years) and 74 elderly (≥60 years) patients. Excluded: congenital heart disease, rheumatic heart disease, valvular heart disease, coronary heart disease, COPD, pulmonary embolism, diffuse connective tissue disease, malignancy, or combined peritoneal dialysis.

Outcome

All-cause mortality, all-cause hospitalization, and cardiovascular hospitalization at median 32.90 months follow-uphard clinical

Distinct risk profiles for pulmonary hypertension exist between non-elderly (lower uric acid to HDL ratio) and elderly (diabetes mellitus) hemodialysis patients, though elevated NT-proBNP and poor prognosis are common to both.

Main Result

Effect estimate: HR 2.24 (95% CI 1.26-3.98)

p-value: p=0.006

Limitations

Retrospective design
Single-center study

Abstract

BACKGROUND: Pulmonary hypertension (PH) is highly prevalent and associated with increased mortality in patients undergoing maintenance hemodialysis (MHD). This study aimed to explore the disparities in the prevalence, risk factors, and prognostic impacts of PH between non-elderly and elderly MHD patients. METHODS: This study included 179 MHD patients with complete clinical records. All patients were evaluated using Doppler echocardiography, and PH was defined as a pulmonary artery systolic pressure > 35 mmHg. RESULTS: The prevalence rates of PH were 24.8% in non-elderly patients and 33.8% in elderly patients. Serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was a predominant risk factor for PH in hemodialysis patients. A lower ratio of uric acid to high-density lipoprotein (UHR) was associated with PH among non-elderly patients, whereas diabetes mellitus served as a specific risk factor for elderly patients. The areas under the receiver operating characteristic curves of these risk factors identified in non-elderly and elderly patients were 0.86 (bootstrap 95% confidence interval (CI) 0.78-0.93) and 0.90 (bootstrap 95% CI 0.82-0.97), respectively. During a median follow-up duration of 32.90 (4.00-61.50) months, the presence of PH notably elevated the risk of all-cause mortality and cardiovascular hospitalization in both non-elderly and elderly patients. Meanwhile, it significantly augmented the risk of all-cause hospitalization (HR: 2.24, 95% CI 1.26-3.98, P = 0.006) in the non-elderly. CONCLUSIONS: Distinct risk profiles for PH were identified between non-elderly and elderly MHD patients, offering valuable clinical data for the development of early detection and prevention strategies based on age stratification.

Bookmark

View Full Paper