Pulmonary Hypertension in End-Stage Renal Disease Patients with Maintenance Hemodialysis

Chung, Chang Su; Lee, Young Ki; Choi, Jong Soo; Lee, Seung Min; Song, Young Rim; Kim, Soo Jin; Park, Tae Jin; Oh, Jieun; Seo, Jang Won; Yoon, Jong Woo; Koo, Ja Ryong; Kim, Hyung Jik; Noh, Jung Woo; Choi, Seonghoon

Abstract

PURPOSE
Pulmonary hypertension can occur from diverse etiologies. It was reported that pulmonary hypertension also complicated dialysis patents, but the exact mechanisms were not determined. The aim of this study was to evaluate the prevalence and risk factors of pulmonary hypertension in maintenance hemodialysis patients. In addition, we studied the relationship between pulmonary hypertension and arteriovenous access.
METHODS
Fifty-nine chronic hemodialysis patients underwent clinical evaluation. Pulmonary artery pressure (PAP) was estimated by Doppler echocardiography. Pulmonary hypertension was defined as PAP > or =35 mmHg.
RESULTS
Mean PAP value of subjects was 39.3+/-13.2 mmHg. Pulmonary hypertension was found in 31 (53%) of patients receiving hemodialysis (49.0+/-10.6 mmHg; range 37 to 84 mmHg). Clinical and biochemical parameters did not differ significantly between patients with pulmonary hypertension and without pulmonary hypertension. In 19 patients, PAP was elevated from 27.8+/-10.2 mmHg to 41.8+/-11.9 mmHg (p<0.001) after onset of hemodialysis via arteriovenous fistula. And pulmonary hypertension developed in 12 of 15 patients with normal PAP after onset of hemodialysis treatment.
CONCLUSION
The prevalence of pulmonary hypertension was high, and hemodialysis via arteriovenous access may be involved in the development of pulmonary hypertension.