Pulmonary hypertension in maintenance hemodialysis patients and factors leads to it

ABSTRACT

The aim of this study was to evaluate the prevalence of primary pulmonary hypertension (PH) among Hemodialysis patients and search for possible leading factors. The prevalence of PH was prospectively estimated by Doppler echocardiogram on maintenance hemodialysis patients on the day post dialysis. PH (> 30 mm Hg) was found in 41.3% patients . The hemoglobin and bicarbonate levels were significantly lower in the PH subgroup. 

                

Objective: To determine the prevalence of pulmonary hypertension among chronic hemodialysis patients and the factors leading to pulmonary hypertension.

Material and Methods:

Study design: Cross sectional

Setting: Department of nephrology, Sindh Institute of Urology and Transplantation.

Duration of study: From 19, September 2011 to 19 March, 2012.

Subjects and Methods: 179 patients were included who fulfilled the inclusion criteria after taking the informed consent. SPSS version 17 was used to  analyze the data.

Results:

We studied 179 patients ( males were 115(63.7% and females were  65(36.3%) .The mean±SD of age and duration of HD was (33.8±11.9 years and 23.88±22.13 months). All the them had A-V fistula constructed over therir arms. Out of 179 patients, pulmonary hypertension was found in 74( 41.3%) patients. Frequencies and percentage of the factors which led to pulmonary hypertension were studied, in which  Low  Hemoglobin ( <10 mg/dl) was seen in 70(94.6%): Low bicarbonate(< 24 mEque/L) was found in 71(95.94%):  Low serum albumin(3.4mg/dl)  was seen in 55 ( 74.32%)and  high Ca×P  product was obsereved in 14 (18.91%) patients.

Conclusion :

We found there is  substantial numbers (41.3%) of the  patients on maintenance Hemodialysis(HD) who developed Pulmonary Hypertension. This adds more suffering to these patients who are already attached with  high morbidity . By  timely identifying the factors which leads to this PH, we can take measures to correct them  and reduce the morbidity and mortality related to PH in maintenance HD patients.

Key words:

End stage renal disease, Arterio-venous Fistula, Haemodialysis, Pulmonary hupertension.