Prevalence of Pulmonary Hypertension in Patients with Early Stages of Chronic Renal Disease

Aim: Pulmonary hypertension (PHT) was recently described as a cardiovascular complication of chronic kidney disease (CKD). There are many studies on the prevalence of PHT in patients undergoing hemodialysis (HD); however, there are no data on the presence or prevalence of PHT in patients with early-stage kidney disease. Materials and Methods: The demographic and laboratory findings for 172 adult patients with stage 1-5 CKD, as well as Doppler echocardiographic findings were evaluated. Systolic pulmonary arterial pressure (sPAP) was compared according to CKD stage, and also between the patients in stages 1-4 and those in stage 5 with and without AVF. Results: Mean age of the patients was 55.4 ± 15.2 years. Mean sPAP in the entire study group was 34.5 ± 5.7 mmHg and PHT was noted in 90 (52.3 %) patients. Mean sPAP and the prevalence of PHT were similar in the stage 1-4 patients and stage 5 patients, regardless of HD (P=0.86). The serum calcium level was significantly lower and the serum intact parathyroid hormone level was significantly higher in patients with PHT than in those without PHT (P = 0.02, and P = 0.03). Conclusion: The present findings show that the prevalence of PHT in patients with early stage CKD was similar to those with stage 5 CKD. Due to the high morbidity and mortality rates associated with PHT, follow-up of sPAP via Doppler echocardiography might be indicated in all patients with CKD.