Kidney Res Clin Pract.  2015 Mar;34(1):28-34. 10.1016/j.krcp.2015.01.003.

Relationship between pulmonary hypertension, peripheral vascular calcification, and major cardiovascular events in dialysis patients

• Kim SC
• Chang HJ
• Kim MG
• Jo SK
• Cho WY
• Kim HK

• KMID: 2381510
• DOI: http://doi.org/10.1016/j.krcp.2015.01.003

Abstract

BACKGROUND
Pulmonary hypertension (PHT) is a recently recognized complication of chronic kidney disease. In this study, we investigated the association between PHT, peripheral vascular calcifications (VCs), and major cardiovascular events.
METHODS
In this retrospective study, we included 172 end-stage renal disease (ESRD) patients undergoing dialysis [hemodialysis (HD)=84, peritoneal dialysis=88]. PHT was defined as an estimated pulmonary artery systolic pressure >37 mmHg using echocardiography. The Simple Vascular Calcification Score (SVCS) was measured using plain radiographic films of the hands and pelvis.
RESULTS
The prevalence of PHT was significantly higher in HD patients (51.2% vs. 22.7%). Dialysis patients with PHT had a significantly higher prevalence of severe VCs (SVCS> or =3). In multivariate analysis, the presence of severe VCs [odds ratio (OR), 2.68], mitral valve disease (OR, 7.79), HD (OR, 3.35), and larger left atrial diameter (OR, 11.39) were independent risk factors for PHT. In addition to the presence of anemia, severe VCs, or older age, the presence of PHT was an independent predictor of major cardiovascular events in ESRD patients.
CONCLUSION
The prevalence of PHT was higher in HD patients and was associated with higher rates of major cardiovascular events. Severe VCs are thought to be an independent risk factor for predicting PHT in ESRD patients. Therefore, in dialysis patients with PHT, careful attention should be paid to the presence of VCs and the occurrence of major cardiovascular events.

Keyword

Cardiovascular disease; Dialysis; Pulmonary hypertension

MeSH Terms

Anemia
Blood Pressure
Cardiovascular Diseases
Dialysis*
Echocardiography
Hand
Humans
Hypertension, Pulmonary*
Kidney Failure, Chronic
Mitral Valve
Multivariate Analysis
Pelvis
Prevalence
Pulmonary Artery
Renal Insufficiency, Chronic
Retrospective Studies
Risk Factors
Vascular Calcification*
X-Ray Film