Why the study?
While pulmonary hypertension is a strong, independent risk factor for adverse cardiovascular outcomes in the general population, its prognostic impact across stages of chronic kidney disease needed systematic evaluation.
Does the presence of pulmonary hypertension predict adverse outcomes in patients with chronic kidney disease?
Does the presence of pulmonary hypertension predict adverse outcomes in patients with chronic kidney disease?
Pulmonary hypertension is highly prevalent in CKD patients and is associated with significantly increased risks of all-cause mortality, cardiovascular mortality, and non-fatal cardiovascular events.
PH may refine risk stratification in CKD; leaves open whether screening or intervention improves outcomes.
In the general population and in heart disease, pulmonary hypertension (PH) is a strong and independent risk factor for mortality and adverse cardiovascular outcomes. We performed a systematic review and meta-analysis of longitudinal cohort studies of individuals with chronic kidney disease (CKD) of any-stage (also including end-stage kidney disease and kidney transplantation) stratified according to presence/absence of PH. Eighteen eligible studies (10 740 participants) were retrieved. PH had an overall pooled prevalence of 33% (95% CI 28-42) and portended a higher risk of all-cause mortality (RR 2.08; 1.06-4.08), cardiovascular mortality (RR 3.77; 2.46-5.78) and non-fatal cardiovascular events (RR 1.60; 1.28-1.99). PH is highly prevalent in CKD and end-stage kidney disease and may represent a novel factor for mortality and cardiovascular risk stratification, particularly in selected sub-categories. Future high-quality research is required to confirm the need for clinical attention on PH in the CKD setting.
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Bolignano et al. (2018) studied this question.
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