Prevalence of pulmonary hypertension in patients with chronic kidney disease on and without dialysis

Pulmonary arterial hypertension is a newly recognized disease in patients with renal disease. In a recent review, the prevalence of PHT in ESRD patients was reported to be around 40–50%. To evaluate the prevalence of primary pulmonary hypertension among CKD patients on and without dialysis and to compare clinical, hemodynamic, and metabolic variables among patients with and without PH to search for possible etiologic factors. Our study included 99 CKD patients; 65 patients on hemodialysis, 12 on peritoneal dialysis and 22 on conservative management. Detailed medical history, examination, and complete laboratory investigations were obtained. Systolic PAP, EF% and cardiac output were evaluated by Doppler echocardiography and AVF flow by Doppler ultrasound. A high prevalence of pulmonary hypertension was demonstrated among 27 patients (41.53%) receiving long-term hemodialysis with a mean systolic PAP of 49.33 ± 9.18 mmHg; as well as in two patients (16.66%) receiving peritoneal dialysis 43 ± 1.41 mmHg, and in five patients ((22.72%) receiving conservative management 44.8 ± 5.89 mmHg. This study demonstrated a high prevalence of pulmonary hypertension among patients with CKD on and without dialysis. The prevalence was highest among patients with ESRD receiving long-term hemodialysis (41.53%) especially in patients with older age, longer duration of dialysis treatment, higher AV fistula flow, cardiac output.