Why the study?
The study was designed to assess the prevalence of each type of pulmonary hypertension (precapillary, post-capillary, and combined) and evaluate correlations between systolic pulmonary artery pressure and clinical or laboratory variables in ESRD patients undergoing hemodialysis.
There is a high prevalence of pulmonary hypertension (77.3%) in hemodialysis patients, which is independently associated with smoking, dialysis duration, hemoglobin level, and cardiac output.
High PHT prevalence in hemodialysis patients merits vigilance; leaves open whether smoking, dialysis duration, hemoglobin, or cardiac output are modifiable targets.
Objectives We aimed to study the prevalence of each type of pulmonary hypertension (PHT) (precapillary, post capillary and combined) in end stage renal disease patients (ESRD) under haemodialysis (HD). We also studied the correlation between the systolic pulmonary artery pressure (SPAP) and different patient clinical and laboratory variables.Methods This cross-sectional study was conducted on 106 HD patients. Demographic and clinical data, blood samples for laboratory variables of the studied patients were all collected. A standard echocardiography was done. Pulmonary function test was performed with standard spirometry.Results The total prevalence of PHT in our study population was 77.3%. The prevalence of isolated post capillary PHT, pre capillary PHT and combined pre and post capillary PHT was (32.07%, 23.58% 21.69%) respectively. The prevalence of “unexplained” PHT was 0.9%. There were significant positive correlation between SPAP and smoking index (r=0.427, P=0.035), duration of dialysis (r=0.416, P=0.046), ferrittin level (r=0.312, P=0.048), cardiac output (CO) (r=0.683, P=0.000) and AV fistula flow (r=0.529, P=0.018), while there were significant negative correlation between SPAP and hemoglobin (HB) level (r=−0.598, P=0.010) and serum iron (r=−0.572, P=0.049). Multivariate analysis showed significant association with smoking index (P=0.01), duration of dialysis (P=0.032), HB level (P=0.042) and CO (P=0.000) after adjusting other factors.Conclusions In our study there was a high prevalence of PHT in HD patients with a very low prevalence of the unexplained types of PHT. Smoking index, duration of dialysis, HB level and CO were independent risk factors of increased SPAP.
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Abdel‐Ghany et al. (2020) studied this question.
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