Key result
Among maintenance hemodialysis patients in the Democratic Republic of Congo, the prevalence of pulmonary arterial hypertension was 29.4%, which was independently associated with unsecured healthcare funding (aOR 4), arrhythmia, vascular access change, and diastolic dysfunction.
Why the study?
Pulmonary arterial hypertension causes high morbidity and mortality in chronic hemodialysis, but its magnitude and associated factors remain unknown in sub-Saharan Africa.
Cross-Sectional (n=85)
Yes
Answers are grounded in this paper and cite their sources.
Nearly one-third of maintenance hemodialysis patients in this Sub-Saharan African cohort exhibited pulmonary arterial hypertension, which was independently associated with unsecured healthcare funding, vascular access changes, arrhythmias, and diastolic dysfunction.
BACKGROUND: Although cardiovascular diseases in particular Pulmonary Arterial Hypertension (PAH) is associated with, high morbid-mortality in chronic hemodialysis, but its magnitude remains paradoxically unknown in sub-Saharan Africa. The aim of this study was to evaluate the prevalence of PAH and associated factors in chronic hemodialysis in Sub-Saharan African population. METHOD: In a cross-sectional study, patients treated with HD for at least 6 months in 4 hemodialysis centers were examined. PAH was defined as estimated systolic pulmonary arterial pressure (sPAP) ≥ 35 mmHg using transthoracic Doppler echocardiography performed 24 h after the HD session. RESULTS: Eighty-five HD patients were included; their average age was 52.6 ± 15.9 years. Fifty-seven patients (67.1%) were male. Mean duration of HD was 13.3 ± 11 months. With reference to vascular access, 12 (14.1%), 29 (34.1%) and 44 (51.8%) patients had AVF, tunneled cuff and temporary catheter, respectively. The underlying cause of ESRD was diabetes in 30 patients (35.3%). The prevalence of PAH was 29.4%. Patients with PAH had more hyponatremia (11 (44%) vs 10 (16.7%), p = 0.010). In multivariate analysis, unsecured healthcare funding (aOR 4, 95% CI [1.18-6.018]), arrhythmia (aOR 3, 95% CI [1.29-7.34]), vascular access change (aOR 4, 95% CI [1.18-7.51]) and diastolic dysfunction (aOR 5, 95% CI [1.35-9.57] were independently associated with PAH. CONCLUSION: One third of hemodialysis patients exhibit PAH, which is independently associated with low socioeconomic status (unsecured funding, vascular access change) and cardiovascular complications (arrhythmia, diastolic dysfunction).
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Engole et al. (2020) conducted a cross-sectional in End-stage renal disease on maintenance hemodialysis (n=85). Unsecured healthcare funding vs. Secured healthcare funding was evaluated on Pulmonary arterial hypertension (PAH) (aOR 4, 95% CI 1.18-6.018, p=0.026). Among maintenance hemodialysis patients in the Democratic Republic of Congo, the prevalence of pulmonary arterial hypertension was 29.4%, which was independently associated with unsecured healthcare funding (aOR 4), arrhythmia, vascular access change, and diastolic dysfunction.
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